Saving lives and supporting a heart healthy recovery: Heart Foundation Pre-Budget Submission 2022-23
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Saving lives and supporting a heart healthy recovery: Heart Foundation Pre-Budget Submission 2022-23
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Introduction Reduce hospital Reduce heart Save lives through Help avoid hospital References
A message from re-admissions and disease innovative medical admissions and Contact information
the CEO, Victoria support heart attack hospitalisations research build
patients Partner with the Heart High-impact heart healthy communities
Implement the Heart Foundation to boost health research Expand the Heart
Foundation’s new My heart health screening through cardiovascular Foundation’s walking
Heart, My Life program disease ‘Vanguard’ group program
project grants
Saving lives and supporting a heart healthy recovery 1 Heart Foundation Pre-Budget Submission 2022-23
Introduction Victoria already has Australia’s highest number (‘prevalence’)
of heart attacks8 and our aging population means even more
Victorians living with CVD in future.
Kellie-Ann Jolly, Chief Executive Officer, Victoria
COVID-19 severely tested our health system. While our healthcare workers Victoria’s single leading cause of death
have been up to the task, it has tragically cost lives and impacted our mental Heart disease is the single leading cause of death in Victoria:
wellbeing, income and quality of life.
Approximately 4,800 Victorians die every year4
The extent and breadth of the disruption means our recovery – and the pandemic’s
impact – are ongoing. Over 160,000 Victorians live with heart disease5
It has shone a light on where and how we deliver health services, the importance of 36,500 Victorians are hospitalised yearly6
a strong medical research eco-system, and on how we stay fit and healthy. It is the most expensive chronic health disease (over $10 billion nationally) and that
It has compounded existing structural and demographic healthcare delivery burden is mainly incurred in hospitals.7
challenges by accelerating: And sadly, your postcode matters.
the rate Victoria’s population was already aging Our Heart Maps show the significant heart health disparities across Victoria – both
between regional and non-regional but also within metropolitan Melbourne.
the largest ever net quarterly move to the regions, taking expectations of service
Disadvantaged Victorians are more likely to be hospitalised for a heart attack, are
access with them
at higher risk of having a cardiac event, or die from coronary heart disease. For
older Australians with greater health needs choosing to live in coastal areas.1 example:
It also led to a deprioritisation of chronic conditions. Heart disease deaths are at least 50% higher in four regional areas
The May 2020 State Budget rightfully included $91 million ‘to help to catch-up on (Warrnambool/South West, Gippsland, North-West region and Bendigo) than the
treatments that Victorians have deferred during the pandemic’, including cancer state’s lowest region – Melbourne’s inner east.
screening, dental services, and maternal and child health appointments.2 Heart-disease hospitalisation rates around Shepparton are nearly 70 per cent
Our ongoing recovery must also re-prioritise heart health. Up to one in three higher than the state’s lowest region – Melbourne’s inner east
people with, or at risk of, heart disease skipped or delayed visiting a GP during the Physical inactivity in Melbourne’s western region is almost 30 per cent higher than
pandemic,3 and it remains one of our most significant health challenges. across the Westgate Bridge in the city’s inner east, which is the lowest.
Saving lives and supporting a heart healthy recovery 2 Heart Foundation Pre-Budget Submission 2022-23
Most disturbingly, more than 560,000 Victorians aged 45 and over have a high risk
of having a cardiac event in the next five years. In the past 18 months, due to the
pandemic, only 40,000 Victorians have had a heart health check – leaving many
not having their risk assessed and appropriately managed.
Victoria already has Australia’s highest number (‘prevalence’) of heart attacks8
and our aging population means even more Victorians living with CVD in future.
But while COVID-19 has challenged us all, our recovery and rebuild presents
opportunities to change and adapt.
Our submission contains practical measures to build on our strong healthcare
foundations and equip Victoria to recover from the pandemic and save lives by
fighting heart disease – Victoria’s single biggest killer.
Yours sincerely
Kellie-Ann Jolly
Chief Executive Officer, Victoria
Saving lives and supporting a heart healthy recovery 3 Heart Foundation Pre-Budget Submission 2022-23
Summary of recommendations
1
Reduce hospital
2
Reduce heart disease
3
Save lives through innovative
4
Help avoid hospital
re-admissions and support hospitalisations by: medical research by: admissions and build
heart attack patients by: partnering with the Heart partnering with the HF to healthy communities by:
partnering with the Heart Foundation to boost heart deliver high-impact heart expanding the Heart
Foundation to drive health screening and health research through Foundation’s walking group
implementation of the Heart management for Victorians cardiovascular disease program, with a particular
Foundation’s new My Heart, at high risk ‘Vanguard’ project grants focus on the regions and
My Life program in Victorian $120K over two years populations most at risk of
$1 million over three years
hospitals developing cardiovascular
$400K yearly for three years disease
$1.2 million over three years
Saving lives and supporting a heart healthy recovery 4 Heart Foundation Pre-Budget Submission 2022-23
Investment
$400k yearly for three years
1 Reduce hospital re-admissions and
support heart attack patients by:
partnering with the Heart Foundation to drive implementation
of the Heart Foundation’s new My Heart, My Life program in
Victorian hospitals
y Life
My Heart, M
se
The problem: heart disea
ng well with
PART 2: Livi
k
Heart Attac
The right care reduces heart attack survivors’ risk of having a second attack
& Angina
and dying9
BUT
A current service gap means patients are not receiving this support when
they need it most – immediately after leaving hospital10,11
AND YET
About 13 Victorians are hospitalised with a REPEAT heart attack daily –
nearly 1 in 3 of all heart attacks
Someone suffers a heart attack every nine minutes and about one in five
will be readmitted within five years12
Heart hospitalisation rates are higher in rural/regional areas – around 70
per cent higher in Shepparton than Melbourne’s inner east
One in five heart attack or heart surgery patients develop clinical
depression13,14 ART HE ALTH
IMPROVE HE
A GUIDE TO
Saving lives and supporting a heart healthy recovery 5 Heart Foundation Pre-Budget Submission 2022-23
What are we asking Government to do?
Invest $400K yearly for three years to help the Heart Foundation’s My Heart, My Life
(MHML) program reach more patients and carers.
MHML is a new, free 6-month support program that fills a service gap by helping
patients recover from the physical and mental scars of a heart attack – from the
moment they enter hospital – and helping reduce readmissions.
Health professional Patient enrols When home, Patient receives Ideally, patient Patient Patient receives Patient
provides Booklet into program by patient receives phone call from attends continues to phone call encouraged to
1 to patient during phoning Helpline, Booklet 2, email Helpline 2 weeks cardiac rehab receive SMS from Helpline continue to access
bedside education. going online or and SMS journey post discharge and emails if 3 months post Heart Foundation
Explains program via SMS from Heart interested discharge support networks
and encourages Foundation and programs
enrolment online & F2F
Initial admission Immediately post-discharge Ongoing
or diagnosis Initial rehabilitation management
Figure 1: My Heart, My Life overview
Saving lives and supporting a heart healthy recovery 6 Heart Foundation Pre-Budget Submission 2022-23
A government investment in My Heart My Life will:
1. SAVE AND IMPROVE LIVES. MHML helps patients to manage their risk and reduce the
likelihood of a repeat heart attack. MHML was piloted in 38 hospitals nationally, and
showed that:
MHML helps patients reduce risk…
Reduced smoking 80% 20%
Had regular blood pressure checks 84% 5% 10%
Had regular cholesterol checks 67% 12% 21%
Lost weight 64% 30% 6%
Increased physical activity 73% 25% 2%
Improved your diet 84% 14% 2%
Reduced salt/sodium in your diet 74% 20% 6%
Reduced stress 45% 39% 16%
Limited your alcohol intake 69% 28% 3%
I did this and maintained the changes I tried to do this but did not maintain the changes I did not do this at all
…and is popular
86% of health professionals are satisfied with
the MHML program (n=38)
88% of patients or carers are satisfied with the
MHML program (n=62)
Only 8% of participants opted out of the 6
months SMS journey
2/3 of health professionals felt enrolment in
the program was easy for the patients
Saving lives and supporting a heart healthy recovery 7 Heart Foundation Pre-Budget Submission 2022-23
2. SUPPORT LOCAL HOSPITAL CAPACITY: 3. SAVE MONEY.
a. Increase cardiac rehabilitation (CR) attendance. The pilot doubled normal Cardiovascular disease is the largest disease contributor of hospital admitted
CR attendance rates (58% versus 28%). CR* is proven to keep patients out of patient expenditure.17
hospital and reduce deaths.15 About $227 million worth of economic and social benefits could result from
b. Improve rural/regional health. Heart disease risk factor and hospitalisation increased CR participation alone over a 10-year period in Victoria.18,19
rates are higher among rural/regional Victorians, and the need for MHML is Heart attacks and unstable angina cost Australian governments $1.9 billion in
even greater. 2017-18.20 In total, they cost individuals, families and carers $4.8 billion, including
productivity losses.21
“Our [Regional] Hospital covers a large portion of Regional Victoria and due
to the large geographic area we require extra support. The Heart Foundation This funding would cover:
‘My Heart My Life’ program gives our population much needed support and
optimises our patients’ overall health outcomes. 1. Accelerated enrolment of cardiology interventional hospitals and rural and
regional coronary care units, and upskilling of their healthcare workers to further
I work in a busy medical ward and find some patients miss out on a detailed enhance service delivery in high-risk areas
education session on their heart event due to time restraints. The booklets are
simplified and allow the patient to easily understand information. I personally 2. Local patient support programs for rural and regional Victorians (health
find peace of mind knowing that the Heart Foundation will follow up with the professional education and training sessions and tailored engagement
patient.” strategies)
– Katelyn, health professional 3. Marketing, resource costs, printing/resourcing/distribution, and evaluation.
The program will help Victorians state-wide. Rural and regional areas will receive
extra emphasis.
c. Improve mental health. Depression, anxiety and frustration double the risk of
a heart attack and have been fuelled by the pandemic. At least a quarter MHML includes structured support from the Heart Foundation Helpline team.
of cardiac patients have depression, and early treatment can decrease The program can be co-branded with Government.
the risk of a heart attack (acute myocardial infarction) and strokes by almost
half.16 MHML provides support and mental health referrals when needed.
‘My Heart My Life’ program gives our population much needed
“A cardiac event is as much a mental battle as it is a physical one” support and optimises our patients’ overall health outcomes.
– Maryanne, heart attack survivor
Saving lives and supporting a heart healthy recovery 8 Heart Foundation Pre-Budget Submission 2022-23
Investment
$120k over two years
2 Partner with the Heart Foundation
to boost heart health screening and
management for Victorians at high risk
The problem
More Victorians are at high risk of having a heart event compared to NSW,
WA, SA and Queensland (per capita)
AND
Victoria has the lowest rate of people having had a heart health check in
the past two years
BUT
Supporting appropriate screening and management can save lives of at-
risk Victorians and reduce the burden on the health system and the Victorian
economy.
Saving lives and supporting a heart healthy recovery 9 Heart Foundation Pre-Budget Submission 2022-23ASR per 10,000 persons
What are we asking Government to do?
Fund the Heart Foundation’s ‘Recall Project’ that works with local general practices
in the western and north-western metropolitan regions to increase the screening and
management of Victorians at high risk.
A government investment will:
• Boost screening and management of heart disease in Melbourne’s west and
north-west. Victoria has the second lowest per capita heart health check rate in
Australia, and 20% lower than the national rate. Most at-risk Victorians reside in
metropolitan Melbourne, with those in the west and north-west living with the most
risk factors, leading to poor heart health outcomes. Rates of coronary heart disease
hospitalisations in west and north-west Melbourne are 25% higher than the state
average, and the highest rates in metropolitan Melbourne.
Save lives. About 76,500 CVD-related events – including heart attack, stroke and death
– could be prevented with the uptake of Heart Health Checks nationally. Further, during National
COVID up to one in three people with, or at risk of, heart disease skipped or delayed 0 20 40 60
visiting a GP,22 and sedentary lifestyles – a critical CVD risk factor – increased.23,24 ASR per 10,000 persons
Help deliver best-practice heart risk management. The current Absolute CVD Risk
(55.4)
Guidelines recommend persons aged 45 and over have their risk assessed every two
years, and more frequently for those at high risk. Yet only 40,000 Victorians have had a
Figure 2: Coronary heart disease hospital admissions (Source: Heart Maps)
heart health check, meaning most Victorians at high risk are not being appropriately
managed and treated to recommended Australian guidelines.
This funding would cover:
1. The Heart Foundation will support general practices to identify at-risk patients who
National
would benefit from a Heart Health Check The current Absolute CVD Risk Guidelines recommend
2. GPs and nurses will use our Victorian Government-funded Heart Health Check Toolkit persons aged 45 and over have their risk assessed every
40 60
and novel technology to personally invite eligible patients and undertake a Heart two years, and more frequently for those at high risk.
Health Check
3. Patients will receive personal and tailored information to help manage their risk factors
ASR per 10,000 persons
Saving lives and supporting a heart healthy recovery 10 Heart Foundation Pre-Budget Submission 2022-23Investment The problem:
$1 million over three years
CVD research saves lives, money, and creates jobs:
• Heart Foundation-funded research has facilitated life-saving
3 Save lives through innovative
medical research by:
breakthroughs including the pacemaker, heart failure treatments
and new imaging techniques
• Investing in the NHMRC-funded CVD workforce returns $9.80 per dollar
spent – the highest return for any condition25
partnering with the HF to deliver high-impact heart health research
• Victoria’s Lead Scientist has demonstrated the research ecosystem is
through cardiovascular disease ‘Vanguard’ project grants
key to Victoria’s post-COVID economic recovery26
BUT
“If we don’t have funding, research will stop – and it can’t stop. Look at Hamish now,
Further investment in CVD research is needed:
from being this sick boy on life support, to a valued member of the community.”
• COVID-19 has reduced CVD research output and devastated the
- Lyn, mum to Hamish
research eco-system27
• CVD hospitalises someone every minute, is the most expensive
disease to treat, and is becoming more prevalent as society ages.
Coronary heart disease is Victoria’s single biggest killer.
• CVD researchers struggle to obtain initial funding for novel therapies
and interventions.
Victoria attracts over 40 per cent of Australia’s medical
research funding, and the sector employs 43,000 people
and delivers $1.5 billion in yearly exports.32
Saving lives and supporting a heart healthy recovery 11 Heart Foundation Pre-Budget Submission 2022-23What are we asking Government to do? This funding would cover:
Partner with the Heart Foundation to fund innovative ‘Vanguard’ grants targeting Two Vanguard grants over three years on focus areas to be decided with
novel therapies and interventions. Government
We are Australia’s largest non-Government funder of CVD research and our One possible focus is cardiac arrest – the cause of 40% of sudden cardiac
program attracts strong interest and high-quality applicants. arrest is unknown in young people.
We have: Other possible areas:
invested $59 million in Victorian research over the past 10 years • Cardio-oncology
invested over $670 million nationally (today’s dollars) since 1959 • Women and heart disease
Our collaborations such as the new ‘Global Clinical Trials Initiative’ can bring • Secondary prevention
global investment to Victoria and further support Victoria’s research eco-system. • Predictive modelling / genomics
With Government support, together we can increase our collective impact and • Behaviour changes (diet and exercise)
find the next pacemaker.
• Heart disease and mental health
A government investment in the Heart Foundation’s research The grants can be co-branded with Government.
program will:
Victoria has a world-class medical research base to build on – and protect.
Help save and improve lives. High-impact CVD research is critical to Victoria attracts over 40 per cent of Australia’s medical research funding, and the
improving the prevention and treatment of CVD. sector employs 43,000 people and delivers $1.5 billion in yearly exports.32
Fund the most impactful research. Our research funding program is We welcomed Victoria’s first Minister for Medical Research in June 2020 and
established, well-respected, and robust. We facilitate vetting and analysis of Government commitments of $210 million for medical research and $2 billion for a
funding submissions, and use best practice grant systems, to ensure the best ‘Breakthrough Victoria Fund’.
research is funded. Critically, our research panels are independent, and our
A Government CVD partnership with the Heart Foundation would help support
program helps facilitate knowledge-sharing.
CVD researchers’ pandemic recovery, drive further CVD discovery, and help
Deliver value for money. Investing in the NHMRC-funded CVD workforce Victoria cope with its single biggest killer and contributor to the burden of disease.
returns $9.80 per dollar spent – the highest return for any condition.28 Coronary
heart disease is responsible for the single highest burden of disease29 and
funding should reflect Victoria’s disease burden.
Support Victorian researchers recover from COVID-19. The research sector
was already critical to Victoria’s economy and is key to our post-COVID
recovery30 amid shrinking GDP. CVD researchers have been pulled away from
their research, and interstate competition for researchers was already fierce31.
Saving lives and supporting a heart healthy recovery 12 Heart Foundation Pre-Budget Submission 2022-23CASE STUDY
Dr Dion Stubb (Monash University)
– Treating patients when their heart stops beating
What area of research do you work in?
My research focus is on heart emergencies, like cardiac arrest. My team and I are
looking at how we treat a patient when their heart stops beating and how we can do
a better job of getting more people through that trauma.
What progress and discoveries have you made?
In the past, some cardiac arrest patients were considered too weak to survive
resuscitation. It was believed that some hearts were incapable of being restarted.
We have demonstrated that it is now possible to save someone who was previously
thought ‘too far gone’ – thanks to a new process that combines mechanical CPR with
the use of a miniaturised heart lung machine called ECMO. The better equipped we are at treating heart
emergencies, the more likely it is that patients will
How important was funding from the Heart Foundation for your work? survive and go on to enjoy long and happy lives.
Absolutely crucial. As someone who practices both clinical medicine as well as
clinical studies, I simply wouldn’t have had dedicated time to do research. Dr Dion Stubb
Heart Foundation funding also allowed me to take my idea away from the workbench
and translate it into clinical medicine. The better equipped we are at treating heart
emergencies, the more likely it is that patients will survive and go on to enjoy long and
happy lives.
Saving lives and supporting a heart healthy recovery 13 Heart Foundation Pre-Budget Submission 2022-23The problem:
Investment
$1.2m over three years Victorians do not get the amount of physical activity they need, and this
increases the risk of heart disease and other chronic diseases and can
shorten life expectancy33
4 Help avoid hospital
admissions and build
AND
Low SES communities are disproportionately affected:
• Physical inactivity in Melbourne’s western region is almost 30 per cent
healthy communities by: higher than across the Westgate Bridge in the city’s inner east, which is
the lowest
expanding the Heart Foundation’s walking program, with a • Obesity is higher among lower socioeconomic areas and outside
particular focus on the regions and populations most at risk capital cities34
of developing cardiovascular disease. • Only 17% of people from non-English speaking backgrounds
participate in sport and recreation (state average is 79%)35 and they
need accessible physical activity options
BUT
Walking is free, accessible, and meeting physical activity guidelines means
adults reduce their heart disease risk by as much as 35%.36
Our Heart Foundation walking program keeps people walking and
supports mental health and social connectedness
Over 90% of walkers feel the program is important to their
physical health, mental health, and social connectedness.
Saving lives and supporting a heart healthy recovery 14 Heart Foundation Pre-Budget Submission 2022-23What are we asking Government to do? Support vulnerable communities. The Heart Foundation’s 1,200 walking groups
are popular among diverse groups and include migrant communities, female-
Support the expansion of Heart Foundation’s “Heart Foundation Walking” program
only groups and retirement villages:
to reach more Victorians.
Gender: 79% female
The Heart Foundation has 6362 walkers participating across 248 walking groups
in Victoria. Over 90% of walkers feel the program is important to their physical Average age: 60
health, mental health, and social connectedness. Further, over 23,000 Victorians Groups in disadvantaged areas: 29%
have downloaded a Personal Walking Plan in the four months since launch on 28 Physical inactivity by local government area
Household structure: 28% live alone
March 2021, providing a non-group based participation option.
Annual household income: 41% below $55,000
Physical inactivity in Melbourne’s western region and lower SES communities is
higher, underscoring the need to have an enhanced focus on these cohorts:
Physical inactivity by local government area
75
75
70
70
ASR per 100 persons
National
ASR per 100 persons
National
65
65
60
60
Photo: Heart Foundation Turkish Walking Group, Melton 55
Benefits of a government investment in the Heart Foundation’s
55
walking program:
50
Improve community health. Walking for an average of 30 minutes a day can ASR per 100 persons
lower the risk of heart disease, stroke and diabetes by 30% to5040%. Our program
has turned lives around (see Wantra’s story) and 92 per cent of participants
Not available (73.9)
remain in the program six months post registering. Figure 1: Physical inactivity by LGA Source: Heart Maps
ASR per 100 persons
Saving lives and supporting a heart healthy recovery 15 Heart Foundation Pre-Budget Submission 2022-23
Not available (73.9) Walking is popular. Walking is Victorians’ preferred physical activity. Critically,
according to the Victorian’ Government’s draft ‘Active Victoria’ consultation
paper, it is the activity that inactive Victorians most want to do (p.6).
Supporting Victorians to do the exercise they want means they are more likely to
continue participating.
Deliver economic benefits to local businesses and support local COVID-19
recovery. Economic evidence from 20 different studies found that the cost
benefit ratio of walking interventions is 13:1, that is $13 of benefit for every $1 of
expenditure.
Further, the ‘Good for Business’ report shows the benefit to local businesses of
localised walking and bike riding.
Research has also shown that walking interventions can increase the number
of people entering shops and trading by up to 40 per cent. It benefits directly
those small businesses adversely affected by COVID-19.
This funding would cover:
Expanding our successful Heart Foundation Walking program to reach more
Victorians, with a particular focus on low socioeconomic regions and priority
CVD target audiences.
Delivering supportive public education campaigns to improve the Victorian
public’s understanding of the benefits of walking, increasing awareness of the
programs on offer as well as provide motivation to walk for leisure, recreation
and transport.
Providing member support and customer service to an extensive network of
volunteers.
Saving lives and supporting a heart healthy recovery 16 Heart Foundation Pre-Budget Submission 2022-23CASE STUDY
Mr Soewantra Widjaja (Walker)
Mr Soewantra Widjaja (Wantra) was born in Indonesia, grew up in New Zealand and
now lives happily in Point Cook with his family.
Wantra embarked on a journey to improve his health and fitness, after spending years
in a sedentary job.
“I was tired, stressed out and obese at 92kg. I knew something had to change as I
was heading straight towards a health disaster.”
As Wantra hadn’t exercised in some time, he started out walking. He also joined a
local Heart Foundation Walking group for extra support and motivation.
“Walking in the group and breathing fresh morning air is invigorating. I enjoy the
community spirit, uncovering beautiful walking trails that I did not know existed in my
suburb, learning life lessons from them, and building friendships to the point I now
call Bev (Walk Leader) my adopted Mum.”
Along with regular exercise and healthy eating Wantra successfully lost 17kg, and is still
counting.
Walking group activity has really helped
“Catching up with my walking group members gives me an incentive to schedule a
day or two for my morning walks even during my busy week. Walking group activity me maintain my health and wellbeing.
has really helped me maintain my health and wellbeing.”
Mr Soewantra Widjaja
Saving lives and supporting a heart healthy recovery 17 Heart Foundation Pre-Budget Submission 2022-23References
1 Australian Government Centre for Population, 13 Murphy, B., et al., Anxiety and Depression After a 23 VicHealth 2020, https://www.vichealth.vic.gov.au/-/
Population Statement, https://population.gov.au/ Cardiac Event: Prevalence and Predictors. Frontiers in media/ResearchandEvidence/VicHealthResearchFel-
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less
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36 Australian Institute of Health and Welfare, Australia’s
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2019, Department of Health and Social Care: London.
Sydney
Saving lives and supporting a heart healthy recovery 19 Heart Foundation Pre-Budget Submission 2022-23For further information contact:
Andrew Mosley
Advocacy Manager VIC/TAS
Level 2, 850 Collins Street, Docklands VIC 3008
E: andrew.mosley@heartfoundation.org.au
For heart health information T: 03 8667 5151
and support, call our
Helpline on 13 11 12 or visit
© 2021 National Heart Foundation of Australia, ABN 98 008 419 761 (Heart Foundation)
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HH-SCPE-0019.1.0921 Saving lives and supporting a heart healthy recovery 20 Heart Foundation Pre-Budget Submission 2022-23You can also read
