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Matters of the heart: why 2022 is the year to act on heart failure

Right now, the pressure on primary care is immense and unrelenting. Healthcare professionals, including GPs, have had to find new ways of working during the pandemic under incredibly challenging conditions. We want to thank all those in primary care for the incredible work they continue to do on the frontline as we enter the third year of COVID-19.

Taking action to diagnose heart failure early in primary care can help to alleviate some of the pressure on acute hospital services, whilst delivering better outcomes for patients and benefits across the health system. The signs and symptoms of heart failure are non-specific and associated with a variety of other conditions¹ – but measuring natriuretic peptide levels, such as NT-proBNP, can help you reach an early, accurate diagnosis quickly. NT-proBNP testing gives you the information you need to identify a potential case of heart failure, or rapidly rule it out.² This simple blood test could help to reduce the number of repeat appointments in primary care, giving you back precious time and helping you to get patients on the right track to the specialist treatment they need quickly.³

Early and accurate diagnosis is critical to ensuring people with heart failure can access treatment to help manage their symptoms, improve their quality of life and reduce the risk of long-term complications.⁴ Hannah, from Leeds, was 39 years old at the time of her diagnosis, and was originally misdiagnosed with anxiety because heart failure was not thought to affect someone her age.⁵ By the time she was eventually diagnosed in hospital, she had dilated cardiomyopathy and very severe symptoms. She said, “I have children with special needs and not being able to look after them was incredibly difficult, and the fact I had to be taken away from them for eleven days because of such a late diagnosis.”

New research published in the European Heart Journal shows natriuretic peptide testing has increased in recent years – but three in four heart failure patients in England still do not have a natriuretic peptide test before diagnosis, suggesting there may be more opportunities to diagnose the disease sooner.⁶ Appropriate testing could help prevent hospitalisation and facilitate diagnosis at an earlier, more treatable stage.²

Lots of fantastic work is being done to tackle heart failure around the country. Recently, healthcare professionals in the integrated care system of Humber, Coast and Vale came together in a regional workshop to discuss challenges and solutions to improving heart failure diagnosis. The new PCN service requirements (DES) highlight the early identification of heart failure as a key priority,⁷ which could also help to improve outcomes across England.

Let’s make this the year we take action on heart failure by working together and using the solutions which are already available to reduce pressures across the health system and deliver the best possible outcomes for patients.

To find out more about heart failure diagnosis:

Dr Ashton Harper, Roche Diagnostics UK
Nick Hartshorne-Evans, Pumping Marvellous Foundation
Dr Jim Moore, Primary Care Cardiovascular Society
Colin Hallmark, Alliance for Heart Failure

  1. Hancock, A et al. Barriers to accurate diagnosis and effective management of heart failure have not changed in the past 10 years: a qualitative study and national survey. BMJ Open (2014). https://eprint.ncl.ac.uk/file_store/production/240794/78ADF6C9-CF38-4134-A535-50C810F02603.pdf.
  2. NICE Pathways. Diagnosing and Assessing Acute Heart Failure. (2021) Available at: https://pathways.nice.org.uk/pathways/acute-heart-failure#path=view%3A/pathways/acute-heart-failure/diagnosing-and-assessing-acute-heartfailure.xml&content=view-index.
  3. NICE. Reducing inappropriate use of NT pro BNP: A Quality Improvement project. (2020) Available at: https://www.nice.org.uk/sharedlearning/reducing-inappropriate-use-of-nt-pro-bnp-a-quality-improvement-project
  4. British Heart Foundation, Rushed to hospital: when heart failure isn’t diagnosed early enough (2019) https://www.bhf.org.uk/for-professionals/healthcare-professionals/blog/2019/rushed-to-hospital-when-heart-failure-isnt-diagnosed-early-enough
  5. Pumping Marvellous, Roche Diagnostics UK. Heart Failure: The Hidden Costs of Late Diagnosis (2020). https://hfreport.roche.com/image/6721401/Roche%20HF%20report%20portrait%20final.pdf
  6. Roalfe, A et al. Long term trends in natriuretic peptide testing for heart failure in UK primary care: a cohort study. European Heart Journal (2021). https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehab781/6437771
  7. NHS England. Network Contract Directed Enhanced Service – cardiovascular disease prevention and diagnosis: supplementary guidance (2021) https://www.england.nhs.uk/publication/network-contract-directed-enhanced-service-cardiovascular-disease-prevention-and-diagnosis-supplementary-guidance

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