Inequalities in access to care for patients with ischaemic heart disease.

British Journal of General Practice, June 2004 411 evaluated in US settings predominantly with self-selected well educated participants.9 It is being rolled out nationally before the local evaluation is completed, and despite the fact that initial results from the evaluation suggest poor uptake.10 More disappointing is that the Department of Health may find that they have bought a time-share when, in fact, there was an equally good cottage around the corner. The Angina Plan, for example, is a UK developed and evaluated self-management programme for people with recently diagnosed stable angina, which is facilitated by a health professional. In a randomised, controlled trial it was shown to reduce frequency of angina by over 40% while reducing physical limitation.11 A community cardiac rehabilitation team at Darlington Primary Care Trust devised an innovative programme using the Angina Plan in a leisure centre, which was a finalist in the recent Department of Health’s Health and Social Care Awards, but this has not attracted the sort of attention of the brightly coloured foreign import. Let us learn from abroad, but do it wisely and without forgetting the great resources for effective innovation on our own doorstep.