What is the Alliance for Heart Failure?
The Alliance for Heart Failure is a coalition of charities, patient groups, professional bodies and healthcare companies working together to raise the profile of heart failure in Government, the NHS and media.
Current provision for heart care and well-being in the UK is inconsistent. Heart failure is often poorly diagnosed in primary care1, and public awareness is low. The Alliance for Heart Failure’s mission is to achieve better outcomes for people with heart failure by ensuring timely diagnosis and access to the right care and support. This includes access to specialist cardiology care, which has been consistently shown to deliver better outcomes for patients.2
Heart failure is usually a progressive condition, and there is significant potential for the patient’s health to deteriorate if left unmanaged.3 However, good medical therapy can greatly improve survival and quality of life.4, 5
Who are the Alliance for Heart Failure members?
Membership is open to charities, patient groups, professional bodies, public sector organisations and corporate members with an interest in heart failure.
Alliance member organisations are: Abbott Laboratories; Bayer; British Association for Cardiovascular Prevention and Rehabilitation; British Association for Nursing in Cardiovascular Care; British Society for Echocardiography; British Society for Heart Failure; Cardiomyopathy UK; Cardiovascular Care Partnerships; Education for Health, Medtronic UK; National Heart & Lung Institute; Novartis Pharmaceuticals UK Ltd; Pumping Marvellous Foundation; Roche Diagnostics Ltd; South East Clinical Network, UK Clinical Pharmacy Association.
Co-Chairs are: Professor Iain Squire (British Society for Heart Failure) and Joel Rose (Cardiomyopathy UK).
What are the aims of the Alliance for Heart Failure?
The purpose of the Alliance is to raise the profile of heart failure in Government, the NHS and the media and improve outcomes for people with heart failure. Members of the Alliance collaborate on overarching policy issues in the aim of securing prioritisation of heart failure and improving access to care, treatment and services for people with heart failure. Members remain independent, but the shared mission to deliver timely diagnosis and improve access to the right care and support is strengthened by joining forces.
How is the Alliance for Heart Failure funded?
The Alliance is supported and funded by Abbott Laboratories, Bayer, Medtronic UK, Novartis Pharmaceuticals UK Ltd, and Roche Diagnostics Ltd.
The inaugural meeting of the Alliance was held in September 2015, initiated by Novartis Pharmaceuticals with funding provided by Novartis Pharmaceuticals and Medtronic Limited.
The Alliance and the All Party Parliamentary Group for Heart Disease Living with Heart Failure Inquiry
Several Alliance members were co-opted onto the Advisory Panel for the Inquiry into ‘Living with Heart Failure’ set up by the APPG for Heart Disease. Both the APPG and the Inquiry Steering Group were chaired by Stuart Andrew MP. The Inquiry published its findings in autumn 2016.
The Inquiry Advisory Panel was made up of representatives from key organisations and areas with expertise in heart disease, and its role was to advise the Inquiry Steering Group on key issues such as the scope of the Inquiry, what evidence should be sought, and from whom, and the content and recommendations of the report. The Alliance views the Inquiry as an opportunity to highlight the positive work that has already been done in producing guidelines and standards, and to support their implementation.
Key heart failure statistics
- Heart failure affects 550,000 people in the UK6, with many more undiagnosed.7 Slow diagnosis is a serious issue, compounded because symptoms are similar to other pathologies like COPD. It can take around four months from presenting symptoms to confirmed diagnosis.8
- Heart failure is debilitating and outcomes are poor: 5 year survival rate is worse than breast or prostate cancer9; 30-40% of those diagnosed with heart failure die within the first year.10
- Heart failure is a major cost to the NHS. It is a leading cause of hospital admission in over 65s11 and is one of five long-term conditions responsible for 75% of unplanned hospital admissions.12
- Costs are growing. Hospital admissions for heart failure are projected to rise by 50% within 25 years due to an ageing population.13
- NICE recommends GPs refer patients suspected of chronic heart failure with a previous myocardial infarction or very high levels of serum natriuretic peptides to a specialist within two weeks.14 However, one third of GPs (32%) do not have access to the right diagnostic tests.15
- Only 66% of GPs are confident to diagnose heart failure due to left ventricular systolic function, compared to 95% of cardiologists (the primary clinicians responsible for diagnosis).13
- It is recommended that patients with suspected heart failure have ready access to echocardiograms12, however, there is an acute shortage of echocardiographers in the UK.16
- The National Heart Failure Audit 2013-14 reveals that:17
i. ~80% of patients admitted to hospital with symptoms of heart failure are seen by a heart specialist in some capacity both on first admission and on readmission (indicating that one in five is not receiving specialist input).
ii. ~60% of patients on general medical or other wards were seen by a heart failure specialist (indicating that two in five are not seen by a specialist).
iii. This may have a detrimental impact on outcomes: only 7% of hospital patients treated in cardiology wards died in hospital versus 11% of patients treated on general medical wards and 14% of patients on other wards.
iv. Men are more likely to have input from a heart failure specialist or cardiologist than women
1 Department of Health. Cardiovascular Disease Outcomes Strategy: Improving outcomes for people with or at risk of cardiovascular disease. 2013. Available at: https://www.gov.uk/government/publications/improving-cardiovascular-disease-outcomes-strategy [Accessed July 2016]
2 NICOR (National Institute for Cardiovascular Outcomes Research). National Heart Failure Audit, April 2014-March 2015.
3 Cardiac Care Network. Strategy for Community Management of Heart Failure in Ontario. February 2014. Available at: www.ccn.on.ca/ccn_public/uploadfiles/files/Strategy_for_Community_Mgmt_in_HF_in_ON.pdf [Accessed July 2016]
4 Cleland JG, Clark AL. Delivering the cumulative benefits of triple therapy to improve outcomes in heart failure: too many cooks will spoil the broth. J Am Coll Cardiol. 2003 Oct 1;42(7):1234-7. Available at: http://www.ncbi.nlm.nih.gov/pubmed/14522487?report=docsum [Accessed July 2016]
5 Gregg C. Fonarow, MD; Nancy M. Albert, MD; Anne B. Curtis, MD; Mihai Gheorghiade, MD; Yang Liu, MS; Mandeep R. Mehra, MBBS; Christopher M. O’Connor, MD; Dwight Reynolds, MD; Mary N. Walsh, MD; Clyde W. Yancy, MD. Incremental Reduction in Risk of Death Associated With Use of Guideline-Recommended Therapies in Patients With Heart Failure: A Nested Case-Control Analysis of IMPROVE HF. J Am Heart Assoc. 2012 Feb;1(1):16-26
6 British Heart Foundation. Cardiovascular Disease Statistics 2014. December 2014. Available at: https://www.bhf.org.uk/~/media/files/publications/research/bhf_cvd-statistics-2014_web_2.pdf [Accessed July 2016]
7 British Heart Foundation. An integrated approach to managing heart failure in the community. 2015. Available at: https://www.bhf.org.uk/~/media/files/publications/healthcare-and-innovations/an-integrated-approach-to-managing-heart-failure-in-the-community—sirhf1.pdf [Accessed July 2016]
8 Hall & Partners. Novartis LCZ696 – Source of Business Quantitative Research UK Report (Commissioned by Novartis). November 2014.
9 Stewart et al. Population impact of heart failure and the most common forms of cancer. Circulation: Cardiovascular Quality and Outcomes. 2010. Available at: http://circoutcomes.ahajournals.org/content/early/2010/10/05/CIRCOUTCOMES.110.957571.full.pdf [Accessed July 2016]
10 Cowie MR, Wood DA, Coats AJ et al. Survival of patients with a new diagnosis of heart failure: a population based study. Heart. 2000. 83: 505–10. Available at: http://heart.bmj.com/content/83/5/505.long [Accessed July 2016]
11 NICE. Acute heart failure: diagnosing and managing acute heart failure in adults. October 2014. Available at: https://www.nice.org.uk/guidance/cg187 [Accessed July 2016]
12 NHS England. Emergency admissions for Ambulatory Care Sensitive Conditions – characteristics and trends at national level. March 2014. Available online at: http://www.england.nhs.uk/wp-content/uploads/2014/03/red-acsc-em-admissions-2.pdf [Accessed July 2016]
13 NICE. Chronic heart failure: Management of chronic heart failure in adults in primary and secondary care. August 2010. Available at: https://www.nice.org.uk/guidance/cg108 [Accessed July 2016]
14 NICE, Chronic Heart Failure Quality Standard. 2015. Available at: https://www.nice.org.uk/guidance/qs9 [Accessed July 2016]
15 Hancock HC 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. Available at: http://bmjopen.bmj.com/content/4/3/e003866.full#T2 [Accessed July 2016]
16 British Cardiovascular Society & Society for Cardiological Science and Technology. Strategic Review of Cardiac Physiology Services in England – Final Report 12/05/2015. 2015. Available at: http://www.bcs.com/documents/SRCPS_Final_Report_12052015_2.pdf [Accessed July 2016]
17 NICOR. National Heart Failure Audit 2013 -14. November 2015. Available at: https://www.ucl.ac.uk/nicor/audits/heartfailure/documents/annualreports/hfannual13-14-updated.pdf [Accessed July 2016]