The number of people on cardiology waiting lists is at the highest level on record in Scotland amid "chronic underinvestment" and a "worrying" increase in deaths from heart disease.  

The British Heart Foundation (BHF) Scotland has warned that decades of progress in reducing mortality from cardiovascular causes is being lost, with hundreds of patients now waiting more than a year to see a cardiologist and over 23,000 people on outpatient lists.

Figures obtained by the charity to coincide with Heart Month reveal that fewer than three in 10 people are being seen within the six-week target time for echocardiograms - a key test to diagnose and monitor certain heart diseases - and fewer than half see a cardiologist within the 12-week target.

Almost 1,200 people have been waiting for more than a year for an echocardiogram and more than 750 have been waiting for more than a year to see a cardiologist.

The longer people wait for diagnosis or treatment, the greater the risk of avoidable ill health, and even premature death.

More than 18,000 people died from heart and circulatory diseases in 2022 in Scotland – the highest number of deaths since 2008.

An increase in premature cardiac deaths and cardiovascular disease has also been seen amongst under-75s, with over 5,354 deaths recorded in 2022.


The BHF says long term underfunding of heart disease in Scotland is to blame.

It said just £3 million has been invested in improving heart disease service over the last 10 years despite Scotland spending an estimated £880 million a year on healthcare costs associated with cardiovascular disease.

The charity also points to the Covid-19 pandemic, widening health inequalities in Scotland, and longstanding and extreme pressure on the NHS over the past decade due to austerity and the effects of an ageing and obese population.

Jonathan Roden, policy and public affairs manager for BHF Scotland, said: “For 60 years, deaths from heart disease were on the decline in Scotland, in part thanks to the medical breakthroughs funded by the BHF, but worryingly that trend has reversed.

“Over the last 10 years, dedicated, world-leading health professionals have worked with the Scottish Government to develop plans to improve heart disease services, but these plans have been repeatedly held back by chronic underinvestment.

“Cardiology services are under more pressure than ever, and more patients are waiting longer than ever, which is leading to poorer patient outcomes.

"The Scottish Government needs to act now and invest in cardiology services, to tackle the trend of increasing cardiac deaths, including coronary heart disease, which is still Scotland’s biggest killer.”

The Herald: Improvements to heart disease services have been held back by 'chronic underinvestment', according to the charityImprovements to heart disease services have been held back by 'chronic underinvestment', according to the charity (Image: PA)

Analysis by BHF Scotland, using data from a Freedom of Information request and cardiology outpatient waiting times, has found a worrying trend across the cardiology pathway.

Between March 2019 and September 2023, the number of people waiting for an outpatient appointment rose from 8,562 to 23,027.

In the last year alone, the waiting list has grown by more than 5000.

FOI data shows that between June 2020 to June 2023 the number of people waiting for an echocardiogram increased from 11,745 to 19,054.

Since 2014 the Scottish Government has published two plans to improve heart disease services in Scotland – the 2014 Heart Disease Improvement, and the Heart Disease Action Plan, published in 2021.

These were developed in conjunction with BHF Scotland and health professionals across the country and received a total of £3 million investment from Scottish Government.

But the charity says further increased investment is necessary to ensure that services are fit for the current and future challenges.

David McColgan, Head of BHF Scotland, said: “People are experiencing debilitating health issues or losing their lives, before they even get the care they need.

"There is a human impact behind these figures – families dealing with grief and loss, worry and anxiety.

“This is a fraction of the funding needed to meet the challenges of cardiovascular disease in Scotland.

"A decade of chronic under investment and lack of focus by the Scottish Government, has left cardiology services unable to meet the pressures they are facing in Scotland.”

Professor David Newby, a consultant cardiologist and chair of cardiology at Edinburgh University's BHF Centre of Research Excellence, said it was "hugely concerning" that patients were experiencing such lengthy delay for cardiology care. 

He added:  “We know this can lead to missed opportunities for treatment, unchecked development of more advanced disease, and poorer outcomes for our patients.

“During these times of extreme pressures, we need renewed focus and support for the cardiology teams across the country so that they can deliver the best care and improve patient outcomes.

“This issue needs to be taken seriously, with steps made to tackle systematic challenges and to ensure patients receive the care they need and deserve.”

The Scottish Government said the figures quoted by the BHF include deaths from all heart and circulatory causes, including strokes. 

They stressed that there has been a 14% reduction in the death rate from coronary heart disease compared to 10 years ago, but accepted that a "gradual increase" had occurred over the past four years.

A spokesman said it is "making progress" in the delivery of its 2021 Heart Disease Action Plan, which aims to minimise preventable heart disease and ensure that people with suspected heart disease have timely and equitable access to diagnosis, treatment and care. 

He added: “Under this Government, the number of cardiology consultants within NHS Scotland has increased by 95.6% from 74.6 whole-time equivalent (WTE) as at September 2006 to 146 WTE as at September 2023.

"We remain determined to drive down waiting times and are working with boards to reduce long waits which have been exacerbated by the impacts of the global pandemic.”