Contemporary review of stress echocardiography workforce within the UK: an EVAREST/BSE NSTEP study
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Stress echocardiography is a key imaging modality for assessing coronary artery disease in the UK. Traditionally, stress echo services were led by consultant cardiologists, but evolving workforce models have increased the involvement of cardiac physiologists and scientists. This study, as part of the National Review of Stress Echocardiography Practice (BSE N-STEP), aimed to evaluate current stress echo workforce structures and test outcomes across a group of UK hospitals to inform future workforce planning. RESULTS: Data were analysed from 8506 stress echocardiograms, conducted between September 2020 and June 2023 across 34 UK hospitals. Based on the supervising workforce, stress echocardiograms were allocated into either a doctor-led (DL) or cardiac physiologist/scientist and nurse-led (CNL) model. 56.9% of stress echocardiograms were DL, while 42.7% were conducted under a CNL model. Physiologists/scientists were the most frequently involved staff (81.9%). The primary indication for stress echocardiography was ischaemia evaluation (89.4%). Dobutamine stress echocardiography was more common in DL services (63.0 vs. 56.3%, p < 0.001), while CNL services performed more exercise stress echocardiography (42.8 vs. 36.4%, p < 0.001). Test positivity rates were similar between DL and CNL models (17.1 vs. 17.7%, p = ns), though the CNL group had a lower complication rate (2.2 vs. 5.3%, p < 0.001). Reporting of stress echocardiograms remained consultant-led in 82% of cases, but physiologist/scientist-led reporting showed an increase over time. Training was primarily provided to registrars/fellows (60.2%), with physiologist/scientist trainees accounting for 32.4%. CONCLUSIONS: This study provides a contemporary overview of stress echocardiography workforce models in the UK, highlighting the increasing role of cardiac physiologists and scientists in supervising and reporting stress echocardiography. Despite these shifts, consultant cardiologists remain central to stress echo reporting. The findings support the integration of multidisciplinary workforce models to enhance service efficiency. These insights will aid in future workforce planning and training strategies to optimise stress echocardiography service provision across the NHS.
Source: Echo Research and Practice
Authors: James Willis, Casey L. Johnson, Samuel Krasner, William Woodward, Annabelle McCourt, Cameron Dockerill, Katrin Balkhausen, Badrinathan Chandrasekaran, Attila Kardos, Nikant Sabharwal, Soroosh Firoozan, Rizwan Sarwar, Roxy Senior, Rajan Sharma, Kenneth Wong, Maria Paton, Jamie O’Driscoll, David Oxborough, Keith Pearce, Shaun Robinson, Adora Mo Wah Yau, Daniel X. Augustine, Paul Leeson, the EVAREST/BSE-NSTEP Investigators, Abraheem Abraheem, Sanjay Banypersad, Sadie Bennett, Henry Boardman, Christopher Boos, Sudantha Bulugahapitiya, Jeremy Butts, Duncan Coles, Joanna d’Arcy, Jacob Easaw, Sarah Fairbairn, Patrick Gibson, Haytham Hamdan, Shahnaz Jamil-Copley, Gajen Kanaganayagam, Guy Lloyd, Ioannis Moukas, Tom Mwambingu, Thuraia Nageh, Antonis Pantazis, Alexandros Papachristidis, Ronak Rajani, Muhammad Amer Rasheed, Naveed A. Razvi, Sushma Rekhraj, Joban Sehmi, Azeem Sheikh, David P. Ripley, Kathleen Rose, Michaela Scheuermann-Freestone, Rebecca Schofield, Ayyaz Sultan, Nancy Spagou, Ross Upton, Gary Woodward, Spiros Zidros
Institutions: Royal United Hospital, John Radcliffe Hospital, University of Oxford, Queen Mary University of London, King's College London, Royal Berkshire Hospital, Great Western Hospital, Milton Keynes Hospital, Milton Keynes Hospital NHS Foundation Trust, University of Buckingham, Oxford University Hospitals NHS Trust, Wycombe General Hospital, Northwick Park Hospital, St George’s University Hospitals NHS Foundation Trust, Blackpool Teaching Hospitals NHS Foundation Trust, University of Leeds, Leeds Teaching Hospitals NHS Trust, University of Leicester, Liverpool John Moores University, Manchester University NHS Foundation Trust, Imperial College Healthcare NHS Trust, Manchester Metropolitan University, University of Bath
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,390
Funders: Lantheus Medical Imaging, Middlesex University, King's College Hospital NHS Foundation Trust, Nottingham University Hospitals NHS Trust, National Institute for Health and Care Research, King's College London, University College London, University of Oxford, Chelsea and Westminster Hospital NHS Foundation Trust, University of Nottingham, Barts Health NHS Trust
OpenAlex ID: W4414992240