Electrocardiogram Screening

Question

Asked by

To ask His Majesty’s Government what steps they are taking to widen the availability of electro- cardiogram screening to detect potential heart problems in young people engaging in sporting activities.

The safety and well-being of everyone taking part in sport are absolutely paramount. The UK National Screening Committee ran its annual call for proposals last year. I understand that it has received a submission through this process about sudden cardiac death screening in young people engaging in sport. The committee, an independent body which advises Ministers and the NHS about screening, is considering the proposal and will make a decision in due course.

My Lords, 12 young people die every week from sudden cardiac arrest—80% of them with no prior symptoms and no family history. Taking part in sport or exercise increases the risk by three times. A simple electrocardiogram, properly interpreted, can detect many of the life-threatening conditions. It is good news that the UK National Screening Committee is looking at this, but what can the Minister tell us about what the Government will do to promote greater awareness of the need for such screening and much wider availability for active young people, not just those who are engaged in elite sports?

There are differences between different bodies as to the exact number, but every death of a young person from sudden cardiac death is clearly a tragedy which takes them too early. The Government are supporting greater understanding in this area by listening to the UK National Screening Committee when it comes up with its suggestions, and ensuring that, through bodies such as Sport England, which has guidance for sports clubs, and through funding for defibrillators, there is greater awareness of the risks of this.

My Lords, “If there is anything I can do to save anyone else’s life, I really want to fight for that”—those are the brave words of Hilary Nicholls just weeks after her daughter, Clarissa, passed away aged 20. Hilary is in the Chamber today. Together with Hilary, Ambassador Lambertini of Italy and I put on a symposium for Italian and UK cardiologists on 28 January, where we learned that, since the introduction in 1982 of Italy’s pre-participation screening programme of anyone engaged in organised sport, there has been a reduction of 89% in sudden cardiac arrests. I ask the Minister whether, irrespective of screening committees, she will undertake to sit with the Italian Sports Minister and learn what they have done to implement a similar programme of testing to help avoid another parent like Hilary grieving for their fit and young children.

I pay tribute to Hilary and all parents who, at the worst moment in their lives, campaign to ensure that nobody has to go through a similar situation. Obviously, I, or another more relevant Minister, would be happy to sit down with Italian counterparts to discuss what more we can do. I will say, however, that we are awaiting the findings of the UK National Screening Committee, and it is right that we go through these proper processes.

My Lords, will the Minister look to use the structures that are already there to get this screening process under way? Will the Government make sure that the academies for football and rugby, which prepare young people for intensive physical activity, take the lead on this? We proposed in the football Bill that we should look after player welfare; this might be an interesting first step down that path.

I am pleased to be able to tell the noble Lord that Sport England and others are already working with charities such as Cardiac Risk in the Young to make sure that screening takes place at a local level. There are additional things that can be done. Buddle, which is Sports England’s site for clubs and community organisations, is looking to further increase the profile of organisations, such as CRY, which organise screening locally in the next refresh of the safety, welfare and well-being section of its website, which should take place imminently.

My Lords, in one study of over 600 patients, the false positive results of screening of this kind were as high as about 70%, and the negative results were about 7%—there probably would have been more had there been longer follow-up. The risk, of course, is that vast numbers of false positives cause massive anxiety, and considerable expense to the health service, with further testing that is completely unnecessary. This happened in my own case over 20 years ago—finally, my heart decided that I was still alive. This is a real issue in this era of preventive medicine: we have to choose the right test, and I doubt the electrocardiogram is accurate enough.

My noble friend makes a really valid point, and it is exactly that sort of issue that the UK National Screening Committee needs to take into consideration when deciding a way forward. To give more information on its process, it is going to undertake a mapping exercise, and, when this is completed, the evidence map will be sent out widely for consultation, so there will be opportunities for people to take part in that.

My Lords, at the very effective seminar that was arranged, it was clear that the screening of high-performance athletes is the area where benefit has been found. I wonder whether the Minister agrees, following on from the very perceptive comment from the noble Lord, Lord Winston, that the complexities interplaying behind sudden cardiac death in the young must be better understood. AI may come forward with a way of screening without this enormous number of false positives, because the danger of false positives is that young people avoid sport and exercise and then develop worse health outcomes in the long term, rather than actually finding ways of coping better for those who do need an intervention to sort out their cardiac abnormality.

I could not agree more with the noble Baroness on that point.

My Lords, I took part in a parliamentary rugby game with the noble Lord, Lord Addington, at Twickenham a couple of weeks ago, where, unfortunately, one of our players collapsed on the pitch with a heart attack. He would not be with us today if there were not someone who was able to use a defibrillator to bring him back around. When I was Health Minister, I saw some very low-cost portable defibrillators —under £100—which I think we should be looking to put in place, with training, in all our sports facilities. I would welcome the Minister’s comments on that.

That is a really good point. The use of automated external defibrillators or the mobile defibrillators that the noble Lord referred to can make a huge difference. In preparation for this Question, I asked how many clubs apply for them through the Sport England funding. It is possible for people to do so, but the numbers are relatively low, in my view. Other organisations and charities fund defibrillators as well. From a DHSC perspective, I understand that the department has put forward funding of £500,000 from August last year to help facilitate the further rollout of defibrillators. They are a vital tool in saving lives in this area.

My Lords, I congratulate the Minister on adding heritage and libraries to her ministerial responsibilities. Clearly, widening access to testing equipment, as well as to resuscitative equipment and properly trained people who can interpret the results, is important in preventing the sorts of sudden bereavements that the Nicholls family sustained, sadly. Will the Government continue to work with organisations such as Cardiac Risk in the Young to help them form partnerships with sports organisations, both amateur and professional, to identify where this testing and resuscitative equipment is, and make sure there are no gaps for young people who take part in sport?

Absolutely. Again, when I prepared for this Question, I asked whether Cardiac Risk in the Young had met a Minister since the election and was told that it had and that it had also had engagement at official level. We are keen to work with a range of organisations, including charities, to learn from them, as well as from health professionals, about what works in practice.