Footnotes

• Acknowledgments All the authors made substantial contributions to the conceptualisation, design of work, data acquisition, validation, drafting the work or revising it critically. All the authors have read and approved the final version of the manuscript and agreed to be accountable for all aspects presented in the article.

• Contributors Dr Stephen Hutchison is the consultant cardiologist who heads this district hospital service and is the senior author. Dr Saad Hasan (Speciality Registrar), Dr Haseeb Ur Rahman (Physician Trainee), Dr Anish Patil & Dr Ciaran Haye (Foundation Programme), Carla Lewis (Advanced Nurse Practitioner) and Samuel Townsend (Physician Associate) have contributed as coauthors in addition to collecting and analysing data and reviewing this article.

• Funding The authors have not received a grant for this article from any funding agency in the public, commercial or not-for-profit sectors.

• Competing interests None.

• Patient consent for publication Not required.

• Provenance and peer review Not commissioned; internally peer reviewed.