Women less likely to get life-saving care for deadly heart condition
Researchers discovered that women are 11% less likely to be referred to a hospital specialist following a diagnosis of the heart valve disease.
Academics noted that the findings reveal "inequities in management and care of this common and serious condition." The study also found differences in care among south Asian and black patients, as well as those from poorer backgrounds.
Aortic stenosis, a narrowing of the aortic valve or the area immediately around it, leads to obstruction of the blood flow from the heart, which leads to symptoms including dizziness, fatigue, chest pain and breathlessness.
The condition is more common in elderly people.
It is not possible to reverse but treatments can include a transcatheter aortic valve implantation (TAVI) or valve replacement surgery.
If left untreated it can lead to serious complications, including heart failure, heart rhythm abnormalities, and death.
The analysis suggests some people are less likely to receive this treatment.
Experts from the University of Leicester examined GP data on 155,000 people diagnosed with aortic stenosis between 2000 and 2022 in England.
Presenting their findings to the British Cardiovascular Society conference in Manchester, experts said as well as women being less likely to be referred for hospital care, they are 39% less likely to have a procedure to replace their aortic valve.
Researchers also found people living in poorer neighbourhoods are 7% less likely to be referred for hospital care after a diagnosis compared to people from wealthier neighbourhoods.
Meanwhile, black patients are 48% less likely to undergo a procedure to replace their aortic valve compared to white patients.
South Asian patients are 27% less likely to undergo a procedure compared to their white counterparts, according to the study, which was funded by the National Institute for Health and Care Research (NIHR) and supported by NIHR Leicester Biomedical Research Centre.
Dr Anvesha Singh, associate professor at the University of Leicester and consultant cardiologist, who was involved in the research, said: 'Previous studies have shown lower rates of valve replacement in women, and clinicians had assumed that women were less likely to be diagnosed with aortic stenosis.
'This analysis using large, real-world data clearly shows that this is not the case, giving us the clearest picture yet of what is happening in day-to-day clinical practice.
'Our study highlights potential inequities in management and care of this common and serious condition. More research is needed to understand the reasons for this and the true prevalence of aortic stenosis in different groups.'
Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation, which supported the research, and consultant cardiologist, said: 'This study of over 150,000 GP records has unveiled disparities in access to aortic valve treatment for women, south Asian and black people, and people living in more deprived communities.
'We don't yet have the full picture, but these findings are concerning and we need more research to understand what is driving the differences seen.
'This will be crucial to enable action to address any underlying causes stopping some people from having access to the heart valve treatment and care they need, when they need it.'
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The Guardian
2 minutes ago
- The Guardian
The Guardian view on GCSE results: the Covid generation has surpassed expectations
Pupils in England, Wales and Northern Ireland have overcome the obstacles placed in their way by the Covid pandemic to a striking degree. The cohort who received their GCSE results on Thursday did not take Sats at the end of primary school. Their crucial transition to secondary education was disrupted, with students missing chunks of formal learning and experiences such as school trips. This year's strong results should thus be celebrated as a triumph over adversity. Teachers deserve enormous credit for stewarding these pupils through what is always a demanding set of tests. Like last week's A-levels, however, these results also give rise to concerns. Chief among these are the widening attainment gaps between richer and poorer areas, and between better-off and disadvantaged pupils. Predictably, the poorest children have suffered the worst effects from Covid disruption. On some metrics, including school attendance, decades of progress have unravelled. The number of candidates passing compulsory resits of maths and English has also declined – a situation rightly described by one exam board chief, Jill Duffy, as a crisis. Rectifying the unjust situation whereby there is no pupil premium after year 11 would be a good start. Bridget Phillipson has already announced the expansion of a scheme offering dedicated support and mentoring to schools in England that are 'stuck'. But while pupils in the north-east and north-west continue to score lower grades on average than those in and around London, this is not a simple tale of north and south. Comparing pre- and post-pandemic outcomes, a new report from the Institute for Government (IfG) highlights complexities that require fresh approaches. While councils have lost most of the power they once had over schools, the significant attainment gap between the least and most successful local authority areas points to some highly localised, place-specific effects. Multiple attempts to boost results in towns such as Blackpool have failed. New thinking and resources will be needed to achieve turnarounds. Another issue is understanding what kinds of schools serve disadvantaged pupils best. Schools with a mix of social backgrounds and abilities are the long-established preference of progressives. But the evidence from the IfG is complex: it finds examples both of disadvantaged pupils benefiting from socially mixed settings, and of them doing better in primary schools where they are clustered – perhaps because teachers there are more focused on their needs. Some London boroughs, meanwhile, are a law unto themselves, outperforming other areas by wide margins despite high levels of disadvantage (evidence suggests Birmingham and Manchester may be on similar trajectories). While the gap between boys' and girls' results shrank slightly this year, differences between ethnic groups are significant yet hard to summarise. When disadvantaged schools are compared, those with higher proportions of pupils with English as an additional language do better. Overall, the results give cause for reassurance about young people's resilience. But relief that some of the worst predictions about the pandemic have not come true must not obscure the fact that more than 40% of pupils missed the crucial grade 4 in maths and English. There are other problems with GCSEs, and exams and assessment in general. But too-rigid rules around resits, and the wider question of how to improve post-16 options, are the most pressing.
BBC News
2 minutes ago
- BBC News
GCSE results: Are we in a Maths and English ‘resit crisis'?
For almost a quarter of pupils taking Maths and English GCSEs this year, it wasn't their first rodeo. Some 23.4% of pupils taking those exams were aged 17 and older - an all-time some of those would have been mature students sitting them for the first time, most would have been school- or college-age pupils taking resits after failing them when they were England, if a pupil doesn't get a passing grade in GCSE Maths and English the first time around, they need to keep studying for them and retaking the exams alongside doing their next course, such as A-levels or resits are held twice a year, in June and resitting are far less likely to pass than those sitting the exams for the first time. This year in England, only 20.9% of English entries and 17.1% of Maths entries for pupils aged 17 or older achieved a passing grade - grade 4 - or of those was James Bonning from Birmingham, who has just achieved a grade 4 in his Maths GCSE on his third told BBC News he needed to pass his exam to get his Level 2 Electrical Training qualification."It's just a relief," he said. "[If I didn't pass] I wouldn't be able to go on a Level 2, and then progress to Level 3 after it."[Passing] opens loads of doors, whether it's electrician or any other trade."Results day has brought good news for James - but Bethany Clarke, who's studying at the same college, has now found out she'll have to retake her exam again. Bethany told BBC News that she found the exams challenging: "The non-calculator, it's definitely harder because obviously you don't have the calculator… but even with the calculator papers it's definitely hard, especially the last paper this year."But she is keeping a positive attitude."Honestly, I feel quite happy," she said. "I didn't get a grade 4, but I was six marks off, so I'm really happy about that."Educationalists are sounding the alarm about Duffy, chief executive of the exam board OCR, has said these pupils end up getting stuck in a years-long cycle of resits - and that we're now seeing a "resit crisis"."We've seen the number of 17-year-olds taking Maths increased by 8% - but 18-year-olds, this year we're seeing that number increased by almost 20%," Ms Duffy told BBC Radio 4's World at One."So, they are re-sitting, and they're entering this dispiriting, if you like, cycle of resits." Not only is it potentially demoralising for pupils to have to sit and fail exams multiple times, but according to Catherine Sezen from the Association of Colleges, it also puts a strain on colleges, who end up having to facilitate these resits."If you think there are 3,400 secondary schools, but there are only around 190 colleges that are doing most of this work, that's where the students go. So, the logistics for the college are completely overwhelming," Ms Sezen told BBC News."It's quite overwhelming in terms of the proportion of English and Maths that you're delivering. If you go into a college, walk down corridors and that's what people are doing."Those are important skills, but it's time for a rethink."Updated guidance from the Department for Education says it is not compulsory for pupils to resit their GCSE maths or English exams, and they should do so only when they - and their school or college - think they are ready. Previously it has been described as a requirement. 'The current GCSE is far too big' We know there is an issue - the data makes this clear. But the question is, why is this happening?One suggestion is that the GCSE Maths and English curricula are expecting too much from her Radio 4 interview, Ms Duffy said that "on maths specifically, we think the current GCSE is far too big and it includes knowledge that isn't required"."For example, you have to memorise the exact values of trigonometry - and that's something we're not even asking A-level students to do," she high-achieving pupils in England, Maths is a success story. The country performs well in international league tables for the subject, and more pupils than before are going on to study Maths at Ms Duffy adds: "We also have to expect that at the other end there's more work that we need to do. It can't be that we have a third of students who aren't getting the basic maths skills that they need at 16." The problem may also be more deeply rooted, and in many cases may go far further back than Duffy told the BBC that when her exam board looked at the transcripts of pupils who had failed, "what's really clear is they're missing out on some of the fundamental Maths and English skills that they should be getting earlier on in their career."So we think there's an awful lot that needs doing in Key Stage 3 [between ages 11 and 14], and even before Key Stage 3, to make sure that they're getting these fundamental skills so that when they get to doing those GCSEs at 16, we don't have so many that are then going on to resit." Catherine Sezen echoed this, and suggested some pupils are on a path to GCSE failure from as early as primary school."If you look at those students who are low achievers at the end of Key Stage 2 [aged 11], about 20% of those students [go on to] achieve a grade 4 at GCSE at 16," she said. "So, this is really quite embedded - it goes right back to reception and to nursery."The government's target is that 75% of children are ready for school at four or five. What about the other 25%?"I suppose I think what you're seeing there is that there are some children who never catch up."Ms Sezen added that in general, pupils from disadvantaged backgrounds do worse in these exams - and for this cohort in particular, the Covid-19 pandemic of 2020 and 2021 could be playing a part, too."The year 11s this year would have been in that primary-secondary changeover phase during the pandemic," she said."What Covid did was exacerbate disadvantage… if you didn't have a laptop, if you didn't have a tablet, if you had parents who were trying to juggle two or three children and perhaps also trying to work from home." 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The Independent
19 minutes ago
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Why GCSE English and maths resits policy is ‘not fit for purpose'
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The proportion of 16-year-old entries in England securing at least a grade 4 in English language has dropped from 71.2 per cent last year to 70.6 per cent this year – although it is above the pre-pandemic year of 2019, when the figure was 70.5 per cent. In maths, the proportion of 16-year-old entries in England securing at least a grade 4 has fallen from 72.0 per cent in 2024 to 71.9 per cent this year, though this is higher than 71.5 per cent in 2019. Students in England are funded to retake maths and/or English until they achieve a GCSE grade 9 to 4. For students with a grade 2 or below, they can either study towards a pass in functional skills level 2 or towards a GCSE grade 9 to 4. PA news agency analysis of figures by Ofqual suggests that 183,450 16-year-olds in England did not achieve a grade 4 or above in English language this year, 1,770 more than in 2024. In maths, it is likely that 174,930 16-year-olds did not achieve a grade 4 or above, 970 fewer than last year. The government launched a curriculum and assessment review last summer. Ahead of the review's final report, which is due in the autumn, education leaders have called on policymakers to look again at the GCSE resits policy. The Education Secretary has said the review will look at how to support young people who do not achieve the 'right level' in maths and English at GCSE. Pepe Di'Iasio, general secretary of the Association of School and College Leaders (ASCL), said: 'Once again we see that the majority of students who retake GCSE English and maths in post-16 education under a government policy of mandatory resits continue to fall short of a grade 4 standard pass. 'It is utterly demoralising for these young people and there has to be a better way of supporting literacy and numeracy. 'We urge the curriculum and assessment review to grasp this nettle.' Catherine Sezen, director of education policy at the Association of Colleges (AoC), said: 'Across the country, educators are working hard to improve outcomes, yet many are left asking what more can be done. 'After a decade of the condition of funding policy, it is time to rethink how we support young people to build essential English and maths skills.' She added that the AoC is calling for 'a more flexible, evidence-based approach' which empowers colleges to meet learners' needs 'without relying on repeated resits that can undermine confidence and motivation'. Paul Whiteman, general secretary of the NAHT school leaders' union, said the current GCSE resit policy was 'not fit for purpose'. He said: 'NAHT has long called for reform of the current policy that forces students into repeated resits, which is demotivating and ineffective. 'What is needed are more appropriate and engaging alternatives to GCSEs in English and maths at KS4. 'Post-16 students who need to continue the subjects must be allowed to study for qualifications that suit their needs and ambitions, rather than defaulting to GCSE resits.' Jill Duffy, chief executive of the OCR exam board, added that Thursday's figures showed a 'resit crisis. She said: 'Tinkering at the edges of policy won't fix this. We need fundamental reform to maths and English secondary education – especially at Key Stage 3 – to support those who fall behind in these crucial subjects.' UK GCSE entries for students aged 17 and over has risen by 12.1 per cent compared with last year. On the rise in the number of post-16 students taking resits, Sir Ian Bauckham, chief regulator at England's exams regulator Ofqual, said it was linked with the 'rising demographic trend'. He told PA: 'If you've got a larger cohort – and proportions getting a grade four are broadly stable – you're going to see more people coming through to resit. 'But the reset of normal grading standards in 2023 probably also plays into it as well.' Sir Ian said: 'My view is that the government's policy that students continue to study English and maths post-16 if they haven't reached that critical grade four threshold is the right thing to do. 'The policy is not that students do multiple resets. The policy is that they continue to study English and maths and sit, when appropriate, either for GCSE or for a functional skills qualification.' Speaking to PA earlier this month, Education Secretary Bridget Phillipson said: 'The curriculum and assessment review is looking at how best we can support 16 to 19-year-olds who don't achieve the right level in maths and English. 'Of course I do want more students – particularly from less well-off backgrounds – to get a good pass at GCSE in English and maths because that's the gateway to so much more. 'But the curriculum and assessment review is going to look at the approach we will take in the years to come.'
