Recipient organisationNIHR Applied Research Collaboration Kent, Surrey and Sussex
NIHR supportRecorded as supported by this research centre
PeriodFeb 2025 — Jul 2025
In plain English
AI plain-English summary
Around 237 million people worldwide have peripheral artery disease (PAD), yet many wait too long for a diagnosis—this study will map exactly where those delays happen by reviewing patient records from the last five years at East Surrey Hospital. PAD narrows leg arteries, causing pain, anxiety, depression, and—if severe—amputation. These outcomes are devastating for patients and costly for the NHS. The problem is that no one has systematically measured how long each step in the diagnostic process takes: from first seeing a GP to getting a specialist referral, undergoing tests, and starting treatment. Without that data, it is impossible to know which part of the pathway is failing. If this research succeeds, it will pinpoint the specific bottlenecks that delay diagnosis. Clinicians and NHS managers could then target those points—for example, by streamlining referral protocols or improving access to vascular testing. The result would be faster treatment, fewer amputations, and better quality of life for people with PAD, while reducing long-term healthcare costs. This is not fundamental science; it is a practical audit of a broken system, designed to fix it.
View original technical description
Approximately 237M people live with PAD worldwide, leading to 74,063 deaths and 0.5M years of lived disability (Lin et al., 2019). People living with PAD often experience anxiety, depression (Aragão et al.,2019) and may require amputation when disease progression is severe (Stella et al., 2019). This is costly for the patient and health system (Crocker et al., 2021), leading to social isolation and inability to work (Wann-Hansson et al., 2005). Urgent action is required to address these negative outcomes to improve the lives of those with PAD; as Dr Alan Hirsh described it, PAD is the “last major pandemic of cardiovascular disease” (McNeal et al., 2024). Better understanding the diagnostic pathway will ultimately lead to timelier care being received and enhance the provision of this, improving the lives of those with PAD. The pervasiveness of PAD was summarised by a member of our PCIE group; “it's not just about knowing if I can walk from my flat to the garage around the corner, it's all the other stuff that I have to live with”. Thus, there is a clear patient-identified need to better understand and expedite diagnosis with PAD.This study will quantify diagnostic intervals experienced throughout the diagnostic pathway for PAD using a case-note review of patients referred to the East Surrey Hospital in the last 5 years. The length between key events (including what dates patients were seen, by whom and where; what tests were conducted and when; and when treatment was started) will be mapped to the Model of Pathways to Treatment. By better understanding where prolonged intervals arise it is hoped that these can be specifically addressed, leading to more timely diagnosis with PAD and ultimately improving the lives of those living with this condition.
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