Heart valve disease (HVD) is common, particularly among people over 50, and early diagnosis can significantly improve outcomes. However, local data has identified important inequalities in access to diagnosis and treatment, particularly among Black African and Black Caribbean communities and people living in areas of deprivation.

Across South East London, there is a risk of missed opportunity for early HVD diagnosis and intervention. Phil MacCarthy, Consultant Cardiologist at King’s College Hospital, explored data and uncovered significant inequalities in TAVI take up, particularly related to ethnicity. He found that the White populations had up to 8 times more TAVI interventions than Black communities. Something needed to be done to understand why, and to address issues to improve TAVI uptake for Black communities.

The South London Cardiac Operational Delivery Network (ODN), working with King’s College Hospital, Guy’s and St Thomas’ NHS Foundation Trust, South East London ICB and community partners, is addressing these inequalities through community engagement, education, and innovative diagnostic services.

Bringing Heart Valve Care Closer to Home

To improve access, Community Rapid Access Valve Assessment Clinics (CRAVAC) have been established in Lewisham and Lambeth. These community-based clinics provide rapid access to specialist assessment and echocardiography for patients with suspected heart valve disease.

Since launching in 2025, the clinics have:

• Assessed over 200 patients
• Identified valve disease or significant cardiac findings in more than half of attendees
• Reduced referral-to-treatment times from approximately 36 weeks to around 35 days
• Increased access for patients from ethnically diverse communities and underserved populations.

Community Engagement and Awareness

Working with local communities, charities and voluntary organisations, the ODN has delivered outreach events, mobile screening programmes and educational campaigns to increase awareness of heart valve disease symptoms and encourage earlier healthcare engagement. These initiatives have helped identify previously undiagnosed patients and improve access to specialist care.

The ODN commissioned Mabadiliko CIC to conduct an in-depth study on attitudes, trust, and engagement for Black African and Caribbean (BAAC) communities.

Read the report. 

GP Referral Information

GPs in Lewisham, Lambeth and Southwark can refer patients aged 50 years and over with a heart murmur detected on auscultation, with or without symptoms such as breathlessness, dizziness or syncope.

Referrals should be made using the South London Community Rapid Access Valve Assessment Clinics referral form available via DXS and sent to: kch-tr.sel.ravac@nhs.net

Clinic locations:

• The Waldron Centre, Lewisham (SE14 6LD) – Mondays
• Stockwell Group Practice, Lambeth (SW9 9BH) – Wednesdays

Our Vision

By delivering care closer to home, improving awareness, and removing barriers to access, we aim to ensure that all patients, regardless of ethnicity, background or postcode, have equitable access to timely diagnosis and life-saving treatment for heart valve disease. The clinics are designed to:

• Reduce waiting times for aortic stenosis diagnosis
• Improve equity across the aortic stenosis and valve disease care pathway
• Deliver care closer to home, in line with the NHS Long Term Plan, by offering timely, local diagnostic

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