At the start of the summer, supportive parliamentarians tabled a series of Parliamentary Questions aiming to establish what is being done post-pandemic to support the diagnosis and treatment of heart failure in primary care.
The first recommendation in our 2021 report was on improving the provision of heart failure services in primary care – particularly around access to NT-proBNP testing and echocardiography.
Impact of Community Diagnostic Centres (CDCs) on echocardiography services
Community Diagnostic Centres have been set up across the country to help relieve the backlog. A Parliamentary Question tabled by Henry Smith MP sought to understand how effective these centres had been in reducing waiting times for echocardiography.
An additional 29,153 scans had been performed by these centres, however no formal assessment has been made of their impact on waiting times.
With a backlog of around 100,000 echos quoted earlier this year and a concern expressed by some echocardiographers that these centres merely relocate an already stretched workforce, it is clear that the echocardiography workforce shortage remains an ongoing problem yet to be formally addressed by the Government.
Access to primary care services for those at risk of heart failure
Another question tabled by Baroness Masham asked about access to primary care services for those most at risk of heart failure. This comes amidst an ongoing shortage of GP appointments.
The Government responded with its commitment to provide another 50 million appointments a year in general practice, as well as reiterating the importance of multidisciplinary heart failure teams.
However, there appeared to be no clear outreach strategy to ensure those most at risk of heart failure can access GP services. With an 11% fall in patients presenting with symptoms during the pandemic, this remains an ongoing concern.
Supporting low performing GP surgeries
Finally, Baroness Masham also questioned what was being done with Quality Outcome Framework (QOF) data to support low performing GP surgeries.
In response to this question the Government outlined a number of promising schemes to increase diagnostic capacity as well as improve remote monitoring and patient education.
However, it appeared no attempts were being made to identify, or support those surgeries and Primary Care Networks in need of more support for heart failure services.
At present, the Alliance is seeking to remedy this with a regional campaign aimed at targeting newly-formed ICSs and clinical networks most in need of scaling up their heart failure services by sharing best practice, providing business models and identifying sources of funding.
The Alliance appreciates the great strain the pandemic has placed on the health service and Government spending. However, from these answers it is clear that there is much room for improvement when it comes to supporting the provision of heart failure services in primary care.
When Parliament resumes, we aim to follow up these responses with activity aimed at raising awareness among policymakers of the increasing burden of heart failure – and the subsequent improvements in primary care needed to meet this challenge.
Hospital admissions for heart failure are set to rise by 50 percent in the next 25 years. We believe much of this can be alleviated by improving the diagnosis, monitoring and treating of heart failure in primary care.