Professor John Chambers, founder of the British Heart Valve Society was awarded the prestigious Mackenzie Medal at the recent British Cardiovascular Society Annual Meeting.

The Mackenzie medal is awarded occasional by the British Cardiovascular Society in recognition of outstanding service to British Cardiology. Professor Chambers has worked tirelessly throughout his career to improve the care of patients with heart valve disease. His work around development of valve clinics is recognised Internationally and he has been a key author of many International guidelines on the care of patients with heart valve disease. He is a key advocate of patient engagement and empowerment and continues this work to the current day with ongoing work through the BHVS. On behalf of the entire British Heart Valve Society we congratulate him on recieving such an esteemed award.

Patient representative Patricia Khan reflects on this important award

CHAMPION OF PATIENTS’ RIGHTS, JARGON-BUSTING PHYSICIAN AND INNOVATIVE EDUCATOR

 John Chambers, Emeritus Professor of Clinical Cardiology at Guy’s and St Thomas’ NHS Foundation Trust and British Heart Valve Society’s founding president, is the new holder of the prestigious Mackenzie Medal. Patient representative Pat Khan reflects on her eight-year association with a stalwart campaigner whose zeal for championing the right of patients to ask questions, challenge decisions and drive-up standards is tireless.

The Mackenzie Medal, bestowed on Professor Chambers by the British Cardiovascular Society, recognises his career-long research into the treatment and care of patients like me with heart valve disease – a distinct category of potentially dangerous dysfunctions and failures affecting each of the four valves.

His mission to create a platform for better-informed and engaged patients became apparent in 2015 at Fitzroy Square, British Cardiovascular Society’s London headquarters; venue for my inaugural attendance at BHVS Council. (The preconceived idea of a group of austere academics could have been daunting had not Professor Chambers sat next to me and put me at ease).

Authoritative but never austere – except, perhaps when judiciously analysing data, guidelines and statements – he is unfailingly approachable, and a generous source of information, explanation and guidance.

Nor are Council members austere. They are dedicated specialists (some at the start of their careers) who, inspired by his commitment, volunteer their time over and above long hours in clinics, theatres, catheter labs and GPs’ surgeries to help prevent an overwhelming epidemic.

Heart valve disease affects an estimated 1.5 million people in the UK, is increasingly common above the age of 65 and easily treated if detected early. Apart from age, the disease can be caused by congenital abnormalities and infections such as rheumatic fever or endocarditis, so it affects younger people, too. Yet it remains under-detected, under-diagnosed and under the radar of most clinicians.

Council’s time is well spent: BHVS has established the first e-learning modules in heart valve disease for healthcare professionals, and the first self-certification process.

My personal insight into this super-specialised world began before the meeting in Fitzroy Square, at St Bartholomew’s Hospital, an institution which has maintained its reputation for excellence in medical teaching and research since 1123.

BHVS hosted an event at St Bart’s to celebrate initiative among young clinicians, and that’s where I first met Professor Chambers and Dr Madalina Garbi, the Society’s new president. The encouragement shown to young doctors, and appreciation for the breadth and scope of their research and ideas, set the tone for subsequent experience of the Society’s endeavours and achievements.

The BHVS Blueprint on care and treatment has been heavily used by NHS England for the heart valve disease sections of the NHS long-term plan, and by BCS (British Cardiovascular Society), BCIS (British Cardiovascular Intervention Society) and SCTS (Society for Cardiothoracic Surgery) for creating the definitive document on Multi-Disciplinary Meetings.

The key function of an MDM is to amalgamate all key aspects of a patient’s clinical care into one source, at the heart of which are the patient’s own views and preferences.  But as Professor Chambers insists, “only a well-informed and engaged patient can assimilate information in such a way as to have views and preferences, and the internet is an unreliable resource.” 

His book, ‘Heart Valve Disease: A Guide For Patients’ answers the need for information from an unimpeachable source.  It was a privilege to be asked to co-ordinate patient input, feedback and perspective on the various stages of the manuscript prior to publication in 2021. I frequently recommend it to those who are confused about their diagnosis or uncertain about treatment.

Lively graphics and ‘bite-size’ presentation take the reader through symptoms and diagnosis to what tests to expect in clinic; different surgical procedures, types of replacement valves available when repair is not an option, and in the case of mechanical valves, the management of warfarin. It covers what to take into hospital, what to expect in the hours before surgery, post-surgical rehab and out-patient care. For me, ten years after surgery and under annual surveillance, it’s as good as 24/7 access to my specialist nurse.

Here’s what others say.

Sally Henniker Major, patient: “…above all, reassuring, helped along by colourful illustrations and summary boxes…very useful for families or carers. To have a book such as this to refer to is invaluable. A GP friend, currently in practice, found it very well written and informative. She said the comparison between ‘trivial’ valve disease and greying hair is one she may be using.”

My own GP, after seeing my copy, said he would put one on the shelf next to his desk “as a reference guide whenever a patient needs extra expert guidance.”

Steve McCabe, patient, Labour MP for Selly Oak and chair of the All-Party Parliamentary Group on heart valve disease: “Compact, simple in the way it’s presented and easy to use. The importance of easy access to information struck me when a friend had a minor stroke, and I was able to compare what little he knew with what’s in this book.

In The Guardian’s special supplement on cardiovascular health (31 March 2023) Professor Chambers explains why more needs to be done. “Only 66% of cardiac centres have valve clinics. These clinics, or the requirement for specialist competencies, need to be universal,” he asserts. Timely, then, that last year, 2022, BHVS published his definitive guide on how to set one up.

Acknowledged as ‘gold standard’ in heart valve disease care and treatment, today’s specialist valve clinic developed out of a research unit set up by Professor Chambers at Guy’s and St Thomas’s Hospitals in 2009 to follow patients with moderate or severe heart valve disease along their entire treatment pathway, from diagnosis to long-term care.

“People need to understand that valve disease can cause irreversible damage and is an important underlying cause of heart failure. They need to know the pros and cons of various treatments, their options, how to evaluate standards of treatment and ensure that clinicians listen to their concerns and preferences. The way forward must include educated and engaged patients. Only then can they be in a better position to assimilate information, ask questions and challenge decisions.”

It may, at times, seem an uphill struggle to ‘publicise’ his values, the Society’s values, to the wider public within the extremely tight budgetary constraints of a registered charitable organisation. Yet his enthusiasm and optimism remain fresh and indefatigable. Progress, with such determination to achieve it, and Council’s potent combination of expertise to accomplish it, is surely unstoppable.