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Report calls for urgent action on heart failure

Urgent action is needed to address the growing burden of heart failure and the impact of COVID-19, according to a report from the Alliance for Heart Failure.

The report – ‘Heart Failure: A call to action’ – makes ten recommendations, including an increase in the number of specialist heart failure nurses – from one to four for every 100,000 people – to meet the growing demand from a rising number of heart failure cases.

Current recommendations, originally published in 2002, suggest one heart failure specialist nurse (HFSN) per 100,000 population, a target that is currently met by 84% of heart failure services. There is evidence that services are overstretched however, with only one in three HFSNs managing to see more than 65% of patients within two weeks of discharge. Despite an increased prevalence of heart disease, and considerable advances in therapies, the recommendation has remained unchanged.

The report points to the growing prevalence of heart failure. Before the COVID-19 pandemic, around 200,000 new cases were being diagnosed every year, with over 900,000 people in the UK affected. The report warns that COVID-19 could result in a significant increase in the disease, highlighting concerns that two-thirds of patients with heart failure are not seeking care during the pandemic as well as significant delays in treatment.

Louise Clayton, Advanced Nurse Practitioner and Co-Chair of the Alliance for Heart Failure said, “Early input by heart failure specialists, including nurses, has been shown to improve patient outcomes and reduce mortality. Around eight in ten patients admitted with heart failure are now identified and seen by specialists during their admission, with around half seen by a specialist nurse.

There is huge variation between hospitals though. In 2018, only six out of ten achieved specialist review rates of over 80%. This postcode lottery for patients must be eradicated.

“The shortage of specialist heart failure nurses was an issue long before the Covid-19 pandemic, but its impact means this needs to be addressed more urgently than ever.”

The Alliance for Heart Failure report’s ten recommendations, which build on those made by the All-Party Parliamentary Group on heart disease in 2016, also include:

  • Initiatives to raise awareness and improve education among the general public and all healthcare professionals likely to encounter heart failure patients.
  • A heart failure champion in each Primary Care Network.
  • That the use of simple NT-proBNP testing for diagnostic purposes be encouraged among GPs, community diagnostic hubs, and emergency departments to eradicate residual regional variation in access.
  • Improvements in the inter-hospital variation of specialist input and review, supported by NHS England and NHS Improvement.
  • An increase in the number of heart failure specialists, including nurses, as well as specialist echocardiographers.

The Alliance for Heart Failure report ‘Heart Failure: A call to action’ was published on 22 February 2021.