Pushing the Boundaries: Improving services for people with heart failure

Service review

July 2007

Some of the recommendations from the Healthcare Commision

• PCTs and commissioners should review their local recorded prevalence for heart failure against national predicted rates and take action as necessary to address shortfalls to ensure that all patients with symptoms of heart failure are identified and properly investigated.
   
• PCTs and commissioners should work together with providers to implement arrangements to ensure that all patients with suspected heart failure have rapid access to the key defining investigations to confirm or refute the diagnosis and its underlying causes in order to determine the most effective course of treatment and care management.
   
• PCTs and commissioners should work together with service providers to ensure that all patients with confirmed heart failure have access to the specialist advice and services they require. This should be achieved by specifying and commissioning cost effective models of multidisciplinary service delivery which are consistent with the recommendations in the National Service Framework for CHD (Standard 11) and NICE guideline.
   
• Service providers in primary and secondary care should aim to ensure that diagnostic clinics provide a 'one stop' service, with, as a minimum, access to clinical assessment and echocardiography on the same visit.
   
• Service providers in primary and secondary care should ensure that all patients with confirmed heart failure have access to all recommended medication at the optimal dose, in line with the NICE guidelines, in order to effectively manage their symptoms and maximise their outcomes.
   
• Service providers in primary and secondary care should develop or adopt methods for evaluating patients' satisfaction and quality of life and act on the findings to improve the quality of services from the patient's perspective.
   
• Professional bodies and cardiac networks should continue to lobby for the development of comprehensive data sets and programmes of audit to evaluate the quality and effectiveness of services delivered to patients with heart failure in all care sectors.