Poor follow up care failing heart failure patients

The British Heart Foundation has warned that heart failure patients in the UK are being let down by limited follow-up care after leaving hospital.

Presented at the European Society of Cardiology (ESC) Congress in Munich, the charity’s research has also revealed that heart failure patients are being let down by insufficient doses of life-saving medicines and dangerously unequal care for women and the elderly.

Researchers found that heart failure patients are more likely to be diagnosed in hospital rather than outpatient settings, that too few patients are being followed-up by their GP after being diagnosed in hospital, and that doses of essential heart failure medicines are too low across the board.

In fact, amongst heart failure patients who survived hospitalisation, only 17 per cent had their heart failure diagnosis recorded by their GP pointing to a lack of communication between hospitals and GPs, suggesting that an accurate record is not being maintained across the system as well as it should be.

Jeremy Pearson, associate medical director from the British Heart Foundation, said: “Heart failure is a cruel and debilitating illness affecting more than half a million people across the UK, and the leading cause of hospital admissions in over 65’s. This study paints a worrying picture of heart failure care in the UK, but identifying the shortfalls is the first step towards addressing them. We need the communication between hospitals and primary care providers to make sure patients with heart failure receive that all-important follow-up care after they leave hospital. We may need to develop targeted, specific health policies for managing heart failure for women, with more research to identify the best way to treat women who have heart failure.”

Mike Holmes, vice chair of the Royal College of GPs, said of the research: "Currently, GPs often have to rely on 'red flag symptoms' that could indicate heart failure, such as breathlessness, swelling in the legs, or general fatigue. Symptoms can be different from patient to patient, and few present with all the tell-tale signs of heart failure, which makes it difficult to identify without access to more sophisticated tests - and particularly challenging within the constraints of a standard 10-minute consultation.

"There needs to be improved communication between hospitals and GPs which, as this research shows, can have a huge impact on the quality of follow-up care for heart failure patients, and the starting point for this will be greatly enhanced, joined up IT systems between primary and secondary care. Ultimately, general practice makes the vast majority of NHS patient contacts, alleviating pressures on secondary care by acting as the gateway to specialist services. We need the tools to be able to do this, which is why the College is calling for £2.5 billion extra a year as part of the Prime Minister's long-term plan for the NHS - on top of what has already been promised in NHS England's GP Forward View, which needs to be delivered in full, and as a matter of urgency."