{
  "abstract": "Background Centralisation of specialised healthcare services is increasingly recommended as it offers the potential to improve clinical expertise, quality of care, and provide economic efficiencies. However, decentralised (cold) sites often face challenges regarding perceived service attrition and diminished specialist accessibility. East Sussex Healthcare Trust has implemented a model where an acute specialist team is established at the decentralised site to mitigate such risks.Methods In October 2025, Inpatient cardiology and interventional services across two district general hospitals in the Southeast of England were consolidated to a single site in Eastbourne District General Hospital (EDGH). A cardiac response time (CRT) was established at the non-centralised site (Conquest Hospital), which has no Coronary Care Unit or a Cardiac Cath lab. The CRT team comprised a cardiac nurse, a cardiology registrar, and a cardiology consultant; to address acute clinical needs, mitigate delays and coordinate transfers to the centralised hub in EDGH. We conducted a retrospective observational analysis of all CRT encounters using routinely recorded service data.Results Between 27 October 2025 and 31 January 2026, the CRT managed 1,225 encounters. The majority of referrals originated from the Emergency Department (ED) and Acute Medical Unit (AMU) (n= 835, 68%). The median time from referral to review was 12 minutes, with 64.3% of encounters assessed within 15 minutes (among 463 encounters with complete timestamps). (Figure 1). The CRT managed to discharge 296 (24.2%) of those seen. Only 117 (9.6%) required inter-site transfer, with the remainder treated locally at the site of presentation. Seventy-three percent (86) of inter-site transfers were completed in less than 24 hours. Only 31 delays to transfer were observed; the commonest reason was bed capacity at EDGH (n = 17, 55%). (Figure 2). Arrhythmia was the most common diagnosis (n=412, 33.6%), and non-cardiac issues accounted for 23.5% of referrals.Conclusion Our preliminary data indicates that a consolidated inpatient cardiac service model, supported by a specialised response team at the non-centralised site is operationally feasible and enhances clinical care. The CRT facilitated quick review times and effective triaging with early specialist cardiology opinion, maintained a streamlined service at the point of entry, and limiting the need for inter-site transfers. Further work is in progress to assess impacts on clinical outcomes.Abstract 420 Table 1Diagnoses categories of referrals to the cardiac response teamCategoryn%Palpitations/arrhythmia41233.6Non-cardiac28823.5SOB/HF13410.9ACS13210.8Syncope/Collapse1169.5Cardiac chest pain675.5Other cardiac conditions655.3Cardiac arrest80.7Other10.1SOB/HF, Shortness of breath/Heart Failure; ACS:Acute Coronary SyndromeAbstract 420 Figure 1Time from referral to review",
  "authors": [
    {
      "affiliations": [
        "Eastbourne District General Hospital, Eastbourne, United Kingdom",
        "East Sussex Healthcare NHS Trust, Eastbourne, United Kingdom",
        "University of Leicester, Leicester, United Kingdom"
      ],
      "name": "Ahmed Kotb"
    },
    {
      "affiliations": [
        "East Sussex Healthcare NHS Trust, Eastbourne, United Kingdom"
      ],
      "name": "Hazem Bashiti"
    },
    {
      "affiliations": [
        "Eastbourne District General Hospital, Eastbourne, United Kingdom",
        "East Sussex Healthcare NHS Trust, Eastbourne, United Kingdom"
      ],
      "name": "Hiten Patel"
    },
    {
      "affiliations": [
        "Eastbourne District General Hospital, Eastbourne, United Kingdom",
        "East Sussex Healthcare NHS Trust, Eastbourne, United Kingdom"
      ],
      "name": "David Kirtchuk"
    },
    {
      "affiliations": [
        "East Sussex Healthcare NHS Trust, Eastbourne, United Kingdom"
      ],
      "name": "Francesca French"
    },
    {
      "affiliations": [
        "East Sussex Healthcare NHS Trust, Eastbourne, United Kingdom"
      ],
      "name": "Ann Pope"
    },
    {
      "affiliations": [
        "East Sussex Healthcare NHS Trust, Eastbourne, United Kingdom"
      ],
      "name": "Hayley Pepper"
    },
    {
      "affiliations": [
        "East Sussex Healthcare NHS Trust, Eastbourne, United Kingdom"
      ],
      "name": "Vicki Posnett"
    },
    {
      "affiliations": [
        "East Sussex Healthcare NHS Trust, Eastbourne, United Kingdom"
      ],
      "name": "Catarina Oliveira"
    },
    {
      "affiliations": [
        "Eastbourne District General Hospital, Eastbourne, United Kingdom",
        "East Sussex Healthcare NHS Trust, Eastbourne, United Kingdom"
      ],
      "name": "Nik Patel"
    }
  ],
  "title": "420 Transformation of inpatient cardiology services: feasibility and keys to successful outcomes",
  "uid": "21ab343e-9c88-5cb8-b722-b33616b0d464"
}