About the project

Heart failure 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. Heart failure (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. 

 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 promptly and accurately recognise the signs and symptoms, 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.  

HIWM has recognised that there is a wide variation in timely access to tests which enable a diagnosis to be made, resulting in subsequent delays in the initiation of disease modifying therapies. Through collaborating with clinical teams in both primary and secondary care, we aim to identify and implement solutions that can be applied to the clinical pathway to enable more timely diagnosis and optimised management of those with HF.  We will do this through delivering education & training and through the implementation of innovations to enable quality improvement. We will work with systems to ensure a robust pathway for HF patients is available for all health care professionals to follow allowing for a better experience for heart failure patients in addition to improved outcomes.

Project ambitions

We will create tools and resources that systems can utilise to enable improvement in heart failure care. We will utilise our IMpulse CVD programme to upskill the primary care workforce, and we will ensure that we use an approach that promotes tackling health inequalities, similar to our InHIP programme of work. We recognise that prevention of heart failure should be a key element to this programme of work also, and so will ensure that our lipid optimisation and blood pressure optimisation programmes are promoted within quality improvement projects.  

We have supported systems to receive funding for the NHSE HF@Home   programme. Heart Failure @Home is to support people with heart failure to manage their own health and to stay well at home, using remote monitoring, supported self-management and education. This can minimise unnecessary face-to-face appointments and reduce avoidable hospital admissions and readmissions. The @home approach can work alongside virtual wards, supporting patients who require acute care in their own homes.  

We will support the systems in implementation of these projects and aim to share the learning across the whole region to enable systems to adopt this innovative approach towards heart failure care.  

The NHSE Cardiac Pathway Improvement Programme(CPIP) team equally have ambitious programmes of work for heart failure, and the HIWM are collaborating with them to support in programmes of work. This will include contributing to regional workshops or webinars, producing a ‘State of the Region’ Heart Failure Report and compiling a heart failure pathway resource.

Find out more

Get in touch with a member of the project team below to find out how you can get involved.