Spotlight on: Kristian Skinner, Heart Failure Consultant

In March, Kristian Skinner was appointed as our dedicated consultant for heart failure to work alongside our team of specialist nurses. This is part of our work with primary and community care to set up an integrated heart failure pathway, one of the service priorities for the Norfolk and Waveney Integrated Care System (ICS).

“Across Norfolk there are 8,600 patients who have been diagnosed with heart failure by their GP, but there are probably another 6,000 to 10,000 who haven’t been diagnosed yet,” said Kristian.

Heart failure patients can rapidly deteriorate, leading to long hospital admissions, and this condition is the most frequent cause of hospitalisation for over 65-year-olds.

“Currently there are gaps in provision and many undiagnosed patients are seen in our Emergency Department,” added Kristian.

“By establishing a dedicated service, we can achieve better continuity of care and a better experience for patients, their families and the clinicians.”

Last year there were 1,600 admissions, accounting for 17,000 hospital bed days for patients with heart failure. Part of Kristian’s job is to provide support for people to manage their own health to stay well at home and to support them to manage symptoms.

“Hospitals admissions are expensive,” he said. ”They can also be harmful for patients, reducing their mobility and independence, and by intervening earlier we hope to avoid them.

“We’re working in partnership with our ICS colleagues to create a pathway to reduce avoidable hospital admissions and readmissions.

“For example, we’re using the Aylsham Medical Unit, Virtual Ward and Same Day Emergency Care for assessing and treating patients who might otherwise end up in hospital.

“We also have a telephone number for patients or their carers to call if they’re deteriorating. We can assess and book them for out-patient appointments and avoid them spending time in hospital.”

The Norfolk and Waveney ICS is working to establish a standardised approach to the treatment of heart failure patients across all the healthcare providers.

This will help patients to be monitored and receive appropriate medications in a timely manner, regardless of where they live.

“The coming months will involve developing pathways to shorten the length of stay, avoid admissions where possible and reduce the risk of admission by speeding up how we adjust the doses of each medication (drug titration),” said Kristian.

Kristian, who’s originally from Hull, worked here from 2018 to 2020, during his registrar training. He then moved to Royal Papworth to work in the heart transplant team before coming back to Norwich.

“Since I was a junior registrar, I always wanted to work in heart failure, and I really wanted to do this at NNUH,” he said.

“I’ve been round the houses a bit. From medical school in Manchester, to working in the North-West to the East of England but I must say this is the place where I like working the most – Norfolk is one of the friendliest parts of the UK and I’ve never worked with a better group of people or a nicer set of patients than those at our hospital.”

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