A new report by the British Heart Foundation (BHF) says disjointed and unequal care, likely exacerbated by the COVID-19 pandemic, is leading to more people dying with heart failure.

The report reveals that prior to lockdown, UK hospital admissions for heart failure had risen by nearly a third over the last five years to more than 100,000 per year. 

This could be in part due to missed opportunities to diagnose and treat people with the condition before they become more unwell and need to be admitted to hospital.

This is supported by research that found 80 per cent of people with heart failure are diagnosed in hospital, even though 40 per cent visited their GP in the previous five years with symptoms such as breathlessness, swollen ankles and exhaustion. 

BHF medical director Professor Sir Nilesh Samani said: “There is no cure for heart failure, but decades of research have given us treatments that allow people to live longer and have a better quality of life with this condition with the right care and support. 

"The key is earlier diagnosis and treatment."

Fragmented care

BHF believes COVID-19 has likely intensified problems around early diagnosis and treatment. 

Latest data shows hospital admissions due to heart failure decreased by 66 per cent by the end of May in England compared to the previous year.

However, there is limited information about how many patients have accessed care and support, if at all, during this period. 

BHF is concerned that many people with heart failure have fallen through the cracks of the NHS since lockdown began, adding to the picture of disrupted and fragmented care.

To address the heart failure care crisis, BHF has laid out a 'blueprint for change' which it says would improve care standards and alleviate pressure on the health service if implemented.

“As our new report finds, too many people are falling through the cracks of our system – a result of stark disparities in heart failure care, likely made worse by the COVID-19 pandemic," said Prof Samani. 

"This is making people more unwell, causing mental distress, and needlessly costing lives.

“As the NHS recovers from the first wave of coronavirus and prepares for its resurgence, it is vital that, as a priority, we not only switch heart failure services back on again but build them back better. 

"By diagnosing people with heart failure early, getting them the specialist care they need, and joining up services to help them avoid admission to hospital, we can relieve some of the unsustainable pressure on the health service, and help more people with this serious condition live well for longer.”

Recommendations

BHF has laid out a series of recommendations in its report, which is supported by: the British Cardiovascular Society, the British Society for Heart Failure, the Primary Care Cardiovascular Society, and Pumping Marvellous.

They all share a common theme – the need for joined up heart failure services equipped to support patients all the way through from diagnosis to end of life care.  

The recommendations include:

  • Making heart failure care more cohesive and relevant for people’s needs. This includes more heart failure services that offer, as standard, diagnostic testing in the community, easier access to specialist care when needed, referral to cardiac rehabilitation and psychological support, and palliative care across GP surgeries, hospitals and other community settings.
  • Improving awareness of heart failure as a long-term condition amongst healthcare professionals so they can better recognise, diagnose, and manage the condition.
  • Using data to drive improvements in heart failure care, including an urgent need to identify the impact the COVID-19 pandemic has had on heart failure patients.
  • Finding ‘heart failure champions’ among healthcare workers at a national and local level to drive improvements in services that support patients from diagnosis to end of life.

Click on the link below to read the report in full.

British Heart Foundation