Researchers warn heart failure care in the UK is ‘inadequate’

The findings by a team at Durham University and Darlington Memorial Hospital, funded by the charity Heart Research UK in Leeds, detail inadequacies in heart failure care, as well as an uncoordinated approach to diagnosis and management of the condition between community staff including GPs and hospitals.

The research showed that clinicians are uncertain about how to diagnose different types of heart failure and about who has overall responsibility for heart failure management.

There was also inconsistency in patients’ access to tests and services and a lack of awareness by health professionals of dedicated heart failure clinics.

Health workers expressed concerns about how to care for heart failure patients affected by other diseases and taking other medicines.

More than 750,000 people live with heart failure in the UK. There have been major advances in treatment in heart care recent years but numbers of patients will increase significantly in years to come.

Lead investigator Prof Ahmet Fuat, of the School of Medicine, Pharmacy and Health at Durham University, said: “Overall, staff told us that they were unsure of who had overall responsibility for heart failure from the point of diagnosis through to the end-of-life.

“Even though the government has spent a lot of money on improving heart services, some of the problems we were told about are the same as those found 10 years ago. This is worrying because it means we are still not getting things right for patients with heart failure.”

The researchers recommend the development of clear lines of responsibility, better education of GPs and hospital doctors who are not specialists in heart care, and that the same high quality services and care pathways are available to all patients.

The project looked at how clinicians diagnose and care for patients with heart failure, which often goes undetected and under-treated, according to experts.

The study involved interviewing GPs, cardiologists, physicians and heart failure nurses, and used the information to carry out a survey of 500 clinicians to compare heart failure care across the UK.

Specialists say the diagnosis and treatment of heart failure is complicated and can lead to wide differences in care. If diagnosed and treated properly, the symptoms can be well controlled and the length and quality of life improved. New treatments are carefully assessed in clinical trials but there is very little research afterwards looking at the way care is delivered.

Barbara Harpham, national director of Heart Research UK, said: “As more people survive heart attacks and with the ageing population, the incidence of heart failure is going to soar and, from this study, it appears that heart failure management and care have not kept pace. The challenge is out there – there needs to be uniform care across the country and everyone involved has to change to give the best to their patients.”

The study findings, published in BMJ Open, will be used to develop further research to improve diagnosis and care for heart failure patients in GP education, end-of-life care, and pathways for its diagnosis and management.