Project Name: Service improvement for the detection and treatment of Heart Failure (“HF”) in secondary care (“Integrated Nurse Programme”)

Project Summary:

The primary aim is to improve the identification, management and outcomes of Acute Decompensated Heart Failure (ADHF) patients with improved delivery of evidence based HF drug therapies, and to reliably provide early post discharge review and transition to the community HFSN team. This may reduce length of stay and is expected to reduce re-admissions and improve prognosis. Additionally, the project aims at establishing a case for future funding of the HF service by the project partner to continue the level of service established in this 12 month (clinical activity) project. 

Planned Milestones:

  1. Collection of baseline data, in line with the above Project Outcome Measures & Data Collection table
  2. Confirmation of recruitment of Band 6 Nurse Specialist
  3. Confirmation of clinical and operational pathway, policy and protocol creation, and readiness to begin the clinical activity (CW Partner shall ensure that the clinical staff covered by the Novartis Financial Contribution are in place, trained and ready to begin clinical activity). 
  4. Collection & submission of 3 months clinical activity data; Project Review meeting to discuss project progress.
  5. Collection & submission of 6 months clinical activity data; Project Review meeting to discuss project progress.
  6. Collection & submission of 9 months clinical activity data; Project Review meeting to discuss project progress.
  7. Collection & submission of 12 months clinical activity data; Project Review meeting to discuss project progress.
  8. Development of business case 
  9. Submission of business case by the CW Partner HF team to relevant body within the NHS Board
  10. Submit final CWP report to Novartis within 3 months completion of the clinical work

Expected Benefits:

Anticipated benefits for patients: 

  • Improved access to optimal diagnosis and treatment;
  • More equitable and consistent care and access to care; and
  • Enhanced experience for HF patients and carers who live with HF due to access to HF specialist service
  • Anticipated benefits for the organisation:
  • Increased overall quality of care and improve equity of access to specialist care for patients with HF.
  • Improved patient flow and reduced total number of inpatient bed days due to HF;
  • Increased proportion of patients with HF being managed in accordance with NICE guideline standards; and
  • Insight into benefits of an inpatient HF service which may inform ongoing redesign and workforce planning.

Anticipated benefits for Novartis:

  • Further opportunities for the appropriate use of cardiology licensed medicines in line with NICE guidelines, including Novartis’s medicine.
  • Improved reputation.
  • Improved professional and transparent relationship and trust between Novartis and the NHS.

Start Date & Duration: 

Start date: September 

Duration: 15 months

UK2308293229

Project Name: Service improvement for the detection and treatment of Heart Failure (“HF”) in secondary care (“Integrated Nurse Programme”)

Partner Organisation(s): Gloucestershire Hospitals NHS Foundation Trust, Gloucester Royal Hospital, Great Western Road, Gloucester, Gloucestershire, GL1 3NN

Completion Date: 3rd December 2024

Outcome Summary:

The primary aims of this project were to improve the identification, management and outcomes of Acute Decompensated Heart Failure (ADHF) patients with improved delivery of evidence-based HF drug therapies, and to reliably provide early post discharge review and transition to the community Heart Failure team. The outcomes reported have shown the project to be successful in achieving its goals, benefitting patients, the NHS Trust and Novartis.

Key Project Outcomes Data:

There was a rapid uptake in demand for the new service with up to 80 referrals per month and as a result the following outcomes have been seen;

  • Emergency admissions with HF as a primary diagnosis have decreased by 11% 
  • The service has also contributed to a 17% reduction in average Length of Stay (from 10.4 days in 2023 to 8.6 days in 2024).
  • The Trusts rankings for patients receiving specialist HF care has improved from 179/193 to 93/193 nationally.

Outcomes:

The percentage of suitable patients referred to the Community HF team has risen from 23% in 2022/23 to 84% post-service launch, surpassing the national average (72%) and demonstrating the service’s success in enhancing continuity of care. As there is known to be a significant survival benefit to patients who receive community follow-up from a HF specialist nurse, this increase in appropriate referrals is likely to improve patient outcomes.

Conclusion:

The successes demonstrated by this project led to overwhelmingly positive feedback on benefits such as shorter lengths of stay, reduced readmissions, and up-to-date management education. The submission of a business case to secure sustainability of the service moving forward was submitted and is currently under consideration.

FA-11368696 | February 2025