Heart Failure

Published on 1 December 2021

About the project

Heart failure (HF) affects around 900,000 people in the UK, and this number is likely to rise, due to an ageing population, more effective treatments, and improved survival rates after a heart attack. HF places a large burden on the NHS, accounting for 1 million bed days per year, 2% of the NHS total, and 5% of all emergency admissions to hospital. (NICOR (2021). Heart Failure Audit 2021 summary report)

Despite advances in treatment, mortality is high with around 30-40% of patients dying within a year of diagnosis. HF can also have a major impact on quality of life with patients experiencing shortness of breath, fatigue and fluid retention. However, evidence has shown that with evidence-based therapies, input from HF specialists and lifestyle changes many people can have a good quality of life.

Poorly managed HF, particularly heart failure with reduced ejection fraction (HFrEF), can result in repeated hospital admissions and is associated with poor prognosis.

The diagnosis of HF relies on clinical expertise to recognise the signs and symptoms promptly and accurately, as well as have timely access to the laboratory tests and imaging procedures needed to confirm the diagnosis. Around 80% of people are diagnosed following a hospital admission, despite many of the symptoms being recognised within primary care settings.

From April 24, HIWM is supporting the national Health Innovation heart failure CVD programme which has the following aims:

To reduce the number of heart failure cases diagnosed in secondary care from 80% to 40% through improved detection & earlier diagnosis and management in a primary care/community-based setting.
To reduce avoidable re-admissions through ensuring the delivery of optimal management via an appropriate care setting.

National ambitions

HIWM will support Primary Care Networks (PCNs) to implement innovations that will enable them to:

Case-find and risk stratify patients using risk stratification tools
Optimise patients on evidence-based therapies.
Improve health care professional and patient awareness of heart failure.
Enable timely diagnosis of heart failure.
Support patients to self-manage their condition.

We will support systems to reduce health inequalities by targeting those populations that fall in the 20% most deprived PCNs and other local priority groups (applying the Core20PLUS5 framework)

We will utilise our clinical educator and embedded HF champions to upskill the primary care workforce.

We will develop case studies to enable us to share good practice.

Local ambitions

We will utilise our developed Heart Failure toolkit to ensure that systems have awareness of the evidence-based pathways.

We will collaborate with the Regional Cardiac Network by contributing to regional events and webinars and update our previous collaborative work on producing a State of the Region report.

We will utilise our embedded HF champions to develop the local workforce to enable them to contribute to quality improvement work and to become HF champions within their PCNs.

We will utilise learnings and case studies from our previous local HF programme to enable spread and adoption at scale and pace.

We will utilise learnings from our contribution of supporting three West Midlands sites in participating in NHSE’s national Managing Heart Failure @Home programme and support the spread and adoption of the innovations that will be evaluated as part of this programme.

We will seek out funding opportunities to support with the development of real world evaluations for key innovations in the HF space e.g. point of care ultrasound and point of care testing of NTPoBNP.