Heart failure Resources

A group of leading nurses have emphasised the crucial role of general practice nurses (GPNs) in reducing heart failure mortality and highlighted the need for more support in terms of specialised training.

In July, a discussion took place during a roundtable hosted by NHS England and the British Society for Heart Failure (BSH). The participants renewed their call for increased funding and protected time to empower GPNs in their efforts to lower mortality rates related to heart failure.

Heart failure (HF) remains one of the most common reasons for hospital admissions and is predicted to rise substantially in the next decade. As many of these patients have other comorbidities, general practice nurses (GPNs) are in the ideal position to assess and identify any possible deterioration before it results in admission. Having a good understanding of HF, terminology and treatment will assist with this, and standardising care and reviews in line with current guidelines will improve care.

Heart failure (HF) is a clinical syndrome distinguished by the inadequate pumping of the heart. It represents a prolonged condition that impacts approximately one million individuals in the UK, a figure surpassing the toll of other ailments such as cancers and strokes. Recognising symptoms like fatigue, fluid retention, and breathlessness can often present a challenge, given that patients may be asymptomatic, and these symptoms are not always specific to heart failure. The utilisation of a simple blood test, such as NT-pro BNP, followed by advanced diagnostics like echocardiography and magnetic resonance imaging (MRI) scans, hold pivotal importance for achieving timely diagnosis, implementing targeted therapies, reducing mortality rates, reducing hospital admissions, and decelerating the progression of the disease. Simultaneously, this approach works towards enhancing the quality of life for patients and reducing health inequality gaps. The recent 25in25 summit convened by the British Society for Heart Failure (BSH) brought together stakeholders from other countries to discuss and address HF mortality rates. This resulted in the participants collaboratively formulating and signing a declaration with the aim of reducing HF mortality in the first year after diagnosis by 25% within the next 25 years.

Heart failure (HF) is a complex clinical syndrome which arises when the heart is unable to pump blood adequately around the body, leading to a range of symptoms from shortness of breath and fatigue to fluid retention. HF care is complex, multifaceted, and is often delivered in varied settings by a range of healthcare workers depending on
local resources and services. To this end, the British Society for Heart Failure (BSH), using Delphi methodology (Barrett and Heale, 2020), has collaborated with cardiologists, specialist nurses, pharmacists, leads from primary and secondary care, as well as those from the wider multidisciplinary team (MDT), to develop an online resource with the aim of supporting this complex management, clinician competence and confidence, and increasing guideline-directed care. This article encourages use of this pathway and raises the importance of HF management from detection to palliative care (Karauzum et al, 2018).

Heart Failure (HF) already affects a million people in the UK. With 200,000 new cases annually, it is the fastest rising cardiovascular disease in the country (British Heart Foundation, 2022). And yet, the public and politicians are barely aware of this condition and the huge impact it has on people’s lives. At Pumping Marvellous, the UK’s only dedicated patient-led heart failure charity, we know too well what can happen when people are blindsided by HF, and how poorly understood it is. We also know how much can be achieved when people are educated and supported to manage their care.

Here, Poppy Brooks, chair of the British Society for Heart Failure’s Nurse Forum, shares some insights from a joint webinar held by the British Society for Heart Failure and the British Association of Cardiovascular Prevention and Rehabilitation (BACPR).
This webinar, held during National Cardiac Rehabilitation Awareness Week 2022, sought to showcase new thinking on cardiac rehabilitation for those with heart failure. The recording is available to watch at: www.bsh.org.uk/webinar-fit-for-the-future/.

In a position statement issued by the British Society for Heart Failure (BSH, 2021), the author said that keeping heart failure specialist services intact would:
... mitigate the significant risk to those living with heart failure and prevent unnecessary pressure on other healthcare providers. The pandemic has already taught us that we need to maintain service provision for this highly vulnerable cohort.’
A statement which has hit home as cases of Covid-19, fuelled by the latest variant, continue to rise.

Heart failure is an insidious long-term condition. It is defined as a clinical syndrome characterised by symptoms including fighting for breath, fatigue and fluid build-up, often noticeable in the ankles, and as weight gain. It is caused by a structural and/or functional cardiac abnormality and results in reduced cardiac output (Ponikowski et al, 2016). Here, Delyth Rucarean, advanced heart failure nurse practitioner, Swansea Bay University Health Board, talks about her role to improve in-patient treatment to heart failure patients and coordinated transition of care once they are fit to be discharged into the community heart failure specialist team.

You may ask why, at the height of a resurging COVID-19 pandemic with nursing staff under inestimable pressure, would the British Society for Heart Failure Nurse Forum launch a Heart Failure Specialist Nurse (HFSN) Competency Framework? Well, in the words of Wendy Preston, head of nursing practice, Royal College of Nursing: ‘Despite the adversity, the pandemic gives us a rare insight and offers the opportunity to build back better provision for the future. This heart failure nurse competency framework is a tool which should be used by everybody as it will set the standard for life after CoViD-19’.’

A diagnosis of heart failure does not come easy — in more ways than one. For many, it is a long and convoluted road. And when you finally get clear answers, it hits you like a train from left field. This happened to me at the age of just 39, when I was diagnosed with heart failure caused by viral myocarditis.