Specialist Nursing For Heart Failure Patients Reduces Costly Readmissions, Says British Heart Foundation Report

Main Category: Nursing / Midwifery
Also Included In: Heart Disease;  Cardiovascular / Cardiology
Article Date: 30 Sep 2008 - 1:00 PDT

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Primary Care Trusts (PCT) could make significant savings by providing heart failure patients with specialist nursing care, according to an independent report published by the British Heart Foundation (BHF).

Conducted by a team at the University of York, the evaluation looked at the heart failure specialist nurse service run by the BHF with funding from the Big Lottery Fund. The research found that BHF heart failure specialist nurses (HFSNs) could save PCT £1,826 per patient (1), and HFSNs involved in the project were responsible for over £8m of savings.

The close monitoring of patients' symptoms that BHF heart failure nurses were able to provide meant that the number of readmissions to hospital was 35% less than in the previous 12 months.

Professor Peter Weissberg, Medical Director at the British Heart Foundation, said: "The dramatic difference in patient readmissions was due to the close support BHF heart failure specialist nurses provided. They were able to give advice and reassurance which enabled patients to understand and manage their condition."

Michael Davies, a Cardiac Consultant at the University Hospital of Birmingham, said: "The findings show that their efforts improve many aspects of heart failure management and their cost effectiveness is clear - they save more money for the NHS than they cost to employ."

The research also found that nurses appeared to have a positive impact on the health-related quality of life of patients. Patients were asked to rate the impact their condition was having on their life. Due to the progressive nature of heart failure, the quality of life for patients typically goes down. However, patients in contact with a BHF heart failure specialist nurse indicated that their condition was having less of an impact on their daily lives six and twelve months after monitoring began.

Heart failure affects about 2% of the population and there are 63,000 new cases each year. The treatment of patients with heart failure costs 1.8% of the NHS budget and accounts for 5% of acute admissions (2).

HFSNs provide care and advice to heart failure patients in their own home or in local clinics. They monitor the patients' condition, adjusting their medications where appropriate. They advise patients on lifestyle changes, particularly diet and exercise, and also provide emotional support to patients and their families to help them cope with a progressive condition and declining health.

The BHF heart failure nurse service was a three year programme which supported, developed and monitored 76 nurses across 26 PCT. Funding for the HFSNs has now expired. However, such was the success of the project that all the PCT have found alternative funding in order to continue to provide this valuable service to heart failure patients.

Professor Weissberg said: "We have shown how effective specialist support to heart failure patients is, from the perspective of both the patient and health professionals. It is now up to the health services to use this information to commission the best possible care for heart failure patients."

(1) Economic modelling of PCT level hospital episode statistics data showed that patients who were able to see an HFSN had a median cost saving of £1,826 compared to patients from the same PCT diagnosed with heart failure but not seen by an HFSN. This figure was over and above the costs of providing the HFSN service.

(2) NHS National Institute for Clinical Excellence. Chronic heart failure: national clinical guideline for diagnosis and management in primary and secondary care. NICE Guideline. 2003. London: NICE.

The British Heart Foundation (BHF) is the nation's heart charity, dedicated to saving lives through pioneering research, patient care, campaigning for change and by providing vital information. But we urgently need help. We rely on donations of time and money to continue our life-saving work. Because together we can beat heart disease.

The British Heart Foundation