A recent national audit of heart failure patients discharged from hospitals has shown that there is a wide variation in how hospitals manage heart failure across the country. The report from the National Heart Failure Audit, which analysed more than 21,000 patient records, suggests about 32 per cent of heart failure patients will die within a year of their hospital admission. However the mortality rate falls to 23 per cent for those are seen by a cardiologist or have access to specialist heart failure service.
As a founder member of the British Society for Heart Failure, I have been passionate in improving the care of heart failure patients. I helped the British Heart Foundation audit the care of patients in primary care for many years through my electronic patient database, Athena. The National Heart Failure Audit is a similar database of patients who have been under secondary (in-patient) care. It is now the largest heart failure audit in the world.
Colchester has had an excellent primary care based heart failure nurse liaison service for many years. These dedicated nurses look after patients in the community, many of whom have recently been discharged from hospital. They optimise the patient’s medication and have been very successful in preventing patients being re-admitted with worsening heart failure. However Colchester Hospital has, until recently, had no dedicated heart failure nurses to look after in-patients.
I am pleased to say that in April 2010, we started to provide such a service with several of our Cardiac Nurse Specialists. Since then, we have fully participated in the National Audit and the nurses are now managing to see virtually all patients with heart failure in the hospital. They ensure that they are on optimal medication and understand their condition prior to discharge. They also liaise with the community team for seamless follow-up.