Heart failure programme
Our heart failure programme aims to improve the recording of heart failure cases in our region, decrease emergency hospital admissions and achieve better health outcomes for people with heart failure.
This programme builds on proven innovations and good practice demonstrated by a number of partner organisations, which can be diffused at scale and pace.
Heart failure is a chronic condition that affects 900,000 people in the UK. The current prognosis is poor, with 30-40% of patients dying within one year of diagnosis. This debilitating, frequently terminal illness is characterised by exacerbations and remissions, multiple hospital admissions, the inability to work and depression. As a result it is one of the most costly chronic diseases in the developed world.
Despite the huge cost associated with this disease, services are fragmented, poorly resourced and in many cases unfit for purpose. Many patients with heart failure remain undiagnosed and are therefore unable to access appropriate healthcare, leading to adverse health outcomes. Across UCLPartners the prevalence of heart failure by clinical commissioning group (CCG) varies but is below the average expected prevalence of 1.2%.
UCLPartners aims to reduce the variation of heart failure service provision across our region by local implementation of evidence-based resources and quality improvement (QI) methods.
Progress to date
We have collated publicly available data sets to deliver a baseline assessment of heart failure services across the our CCGs partners. These utilise core whole system metrics such as, prevalence, heart failure admission rates and prescribing.
Using this data, we created bespoke data packs for each locality. These were used to drive discussions at a stakeholder engagement event. As an outcome of this event 25 delegates submitted action plans (representing 15 partner organisations over 12 localities). These plans informed the development of a programme strategy which will support our partners to build local networks and systems to deliver better services to reduce health inequalities.
Working with our partners
We have worked with local providers and commissioners to design interventions to drive positive quality changes in heart failure.
Through conversations with our stakeholders two main themes emerged as pivotal for the future of services across the region:
- Integrated working – increase recorded prevalence and reduce emergency inpatient admissions
- Capacity and capability – optimise quality and value of care with a skilled and supported workforce
In order to address these issues, many of our partner organisations have identified a UCLPartners locality lead for heart failure. These leads champion heart failure services locally, encourage networking and are responsible for introducing governance structures that regularly review heart failure data and service provision, ensuring continuous improvements.
An expert reference group, convened virtually, provides an opportunity for the leads to peer review and curate a toolkit of evidence-based clinical pathways, consultation templates, checklists and prompts. This toolkit aims to reduce variance and improve service standards across the whole UCLPartners region.
To support the delivery of integrated heart failure pathways, the next phase of our heart failure work is to test the feasibility of such a model with a defined population.
Barts Charity have invested £100,000 to implement an improvement programme within Barts Health NHS Trust, and its three surrounding boroughs: Newham, Tower Hamlets and Waltham Forest. The Three Boroughs programme will link the data of patients with heart failure across primary, secondary and community care. This will be realised through evidence-based education and clinical support tools, including templates and care pathways, facilitated by wide-spread, cross-sector access to EMIS web.
UCLPartners are supporting the Three Boroughs programme and the learnings from this work will be shared in order to inform improvement work in the localities across UCLPartners.
Ongoing support for our partners
This programme is led by Dr Simon Woldman, UCLPartners Clinical Heart Failure Lead.