Heart Failure service adapts to meet rising demand
Around 1,100 people are admitted to our hospital every year with heart failure, yet with the right medications and support from our specialist team, more people are managing their condition at home.
Since 2020 our heart failure service has expanded to meet the needs of our growing elderly population. The team increased from one and half to five full-time equivalent nurses. They offer more nurse-led clinics, review more in-patients and promote a specialist help line for heart failure patients to call for advice.
Historically, the heart failure nurses were seeing heart failure patients mainly on the cardiology wards and this accounted for around 40% of all heart failure admissions. To reach more patients who need their specialist input they started proactively visiting Older People’s Medicine wards and identifying patients there. Now they visit virtually every ward across the hospital and in 2024 the team reviewed approximately 90% of all patients with heart failure. By visiting these patients they’ve been able to promote the dedicated phone line, advertised on helpful fridge magnets, so that once patients are discharged, they can contact our specialist nurses with any concerns about their symptoms. Last year the phone line received 3,500 calls, an increase of 1,000 on the year before.
Kristian Skinner, Consultant Cardiologist, said: “The phone line is manned by a duty nurse within the team. It’s been a great success. Patients with concerns or worsening symptoms who might have gone to their GP or Emergency Department, or just ignored it, can give us a call, and we can either give them advice over the phone, arrange blood tests or urgent review, or redirect them if it isn’t related to their heart failure.”
The team can ask a patient to attend the Aylsham Medical Day unit for review or treatment. This is where patients come for diuretics, iron transfusions and other day case procedures. This can prevent a full hospital admission.
Jo Macfarlane, Heart Failure Specialist Nurse, said: “It’s not an emergency line but in some cases it prevents admissions to ED, especially when we’re getting into the day unit. We see around 10 patients a month as new patients to give outpatient intravenous diuretics and those are pretty much universally people that would have previously been admitted to hospital. And they’re almost all identified through the phone line.”
The service has also introduced new clinics in Cromer and NNUH this year, and with two nurses due to complete their prescriber training the team will be able to double its capacity.
The heart failure team also joins weekly meetings with GP surgeries, the community heart failure team and community virtual ward to identify patients with heart failure whose medication is not optimal or could need more advanced therapies like defibrillators or complex pacemakers. By giving this specialist input earlier on, more patients are benefiting from the optimum medications and can manage the condition at home, with a better quality of life.