The launch of our new Heart Failure Burden Index report means the Alliance for Heart Failure is entering a busy end of the year. As always, there are opportunities to get involved and we are looking for additional support to deliver next year’s campaign at the scale the report’s findings call for.

Launch of Heart Failure: an unsustainable national health emergency

With the generosity of data provided by CSL UK, the Alliance has developed a heart failure burden index which draws on hospital episode statistics and the NICOR audit data to establish which areas of England are in need of the most support.

The report looks at six data areas: prevalence, emergency admissions, readmissions, mortality, specialist nursing referral, and ICB spend.

The key findings:

  • The ten highest-burden ICBs are in the North and Midlands, with NHS South Yorkshire ranked highest in the country.
  • People in the hardest-hit areas die following an emergency admission at twice the rate of those in the least affected areas.
  • Heart failure patients with a hospital visit have risen by a fifth in four years, to 817,000.
  • One in seven diagnosed patients, roughly 116,000 people, are not recorded on a GP register. In some areas this rises to three in ten.
  • On average, 61% of patients are referred to a specialist nurse on discharge. In some areas the figure is as low as 34%.
  • Emergency admissions and readmissions for heart failure cost the NHS in England close to £2 billion between 2021 and 2025.

Our recommendations call on the Department of Health and Social Care and ICBs to take three steps:

  • Require every ICB to commission heart failure services against its own burden data.
  • Build community heart failure capacity, starting in the highest-burden areas.
  • Establish a national heart failure plan, with dedicated national leadership, modelled on the 2015 Independent Cancer Taskforce.

Our thanks to the committee members and clinicians who reviewed the analysis and shaped the recommendations. The full report is available here.

Alliance report informs heart failure pathway transformation work

A recent NHS Transformation Unit case study notes that NHS England’s 2025 review of the case for improving 2–6 week heart failure pathways drew on Alliance for Heart Failure reports, alongside NICE guidance.

The review found that high-risk patients were typically waiting seven to eight weeks for an echocardiogram, despite guidance recommending specialist assessment within two to six weeks.

The programme that followed, led by St George’s University Hospitals with NHS England, redesigned pathways across six pilot sites between October 2025 and March 2026, and a formal evaluation is under way. Read the case study.

Meeting with Dr David Lowe on the OPERA pathway

In October the Alliance met Dr David Lowe, from the School of Health & Wellbeing at the University of Glasgow, to discuss the OPERA pathway (Optimised Pathway for Early Identification of Heart Failure in the Community).

Under the pathway, patients on the heart failure diagnosis waiting list received their ECG, echocardiography and blood tests in a single visit, with results reviewed remotely by the cardiology team, who then sent a management plan to the referring GP. Waiting times fell from 12 months to six weeks, and a consultant could remotely manage 20 patients per clinical session, compared with 10 new patients seen face to face.

The Alliance has agreed to work more closely with Dr Lowe’s team in ensuring those parts of the NHS that can benefit from this pathway do so.

Campaign for 2027

Building on the findings of our report, the Alliance has finalised a campaign that will focus on supporting those areas of the NHS struggling the most from the growing burden of heart failure.

The campaign will ask:

  • Primary Care Networks and Health Innovation Networks to adopt the BEAT HF symptom recognition programme, to speed up diagnosis, treatment and access to specialists.
  • ICBs and PCNs to adopt a digital resource hub for GPs, with a named GP lead in each target area.
  • Every patient to receive a discharge pack with information on community care and follow-up.
  • ICBs to protect and restore heart failure specialist nurse and echocardiography capacity in each of the ten target areas within 12 months.
  • ICBs to publish a costed Heart Failure Improvement Plan within six months of launch.

We are currently looking to expand our clinical, public and parliamentary engagement. If your organisation is interested in supporting the campaign, or you would like to see the plan and discuss in more detail, please contact ahf@3nine.co.uk.

You can follow our progress on LinkedIn.