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Coronary heart disease is the leading single cause of death in the UK and makes a major contribution to the socio-economic differentials in mortality. Nursing interventions have an important part to play in
improving the health and survival of patients with coronary heart disease (CHD).

The Programme appointed Karen Smith, a Nursing Clinical Research Fellow in the Coronary Care Unit and School of Nursing at Ninewell's Hospital and Medical School, Dundee, to a User Fellowship to highlight the links between social deprivation and CHD in the context of nurse education and clinical practice. Her Fellowship aimed (i) to promote the integration of informationabout social deprivation into nurse education and the care of patients with CHD; (ii) to develop clinical protocols in cardiac nursing which take account of social deprivation; and (iii) to undertake a small research project on whether social deprivation predicts health outcomes in patients following first myocardial infarction (MI).

The three aims of the Fellowship were addressed by:

• networking with nursing and educational staff to assess the place of social deprivation and coronary heart disease in the pre- and post-registration nursing curriculum; developing and delivering the post-registration specialist practitioner's qualification (cardiac module), organising and participating in national and international conferences on nursing, social deprivation and CHD and active involvement in the Chief Medical Officer fro Scotland's Coronary Heart Disease Task Force.
• the development of new clinical protocols.
• a retrospective study of 120 patients with first MI, which found that more deprived patients and those with more misconceptions about cardiac disease were less likely to stop smoking following MI. In terms of depression following MI, it was those who were less deprived who benefited most from the Cardiac Rehabilitation programme.

Smith, K. & Graham, E. (2000) 'Social deprivation and the development of clinical protocols' Advancing Nursing Studies, 3, 162-168.