CARDIOLOGY
first admission – with nearly half (48.3%) in emergency care. More than a third (35%) had visited cardiology as an outpatient in the previous six months but had failed to be diagnosed.
The result is a significant cost to the
NHS. Heart failure accounts for approximately 2% of the total NHS budget and 5% of unplanned admissions per year.3
In 2018/19,
it accounted for 862,470 bed days – the equivalent of 2,362 years. The average admission cost £3,690.17 – totalling nearly £400m – while in contrast, an average GP visit costs the NHS only £37.40.4 The report also lays bare the personal toll of a late heart failure diagnosis. Heart failure has worse survival rates than breast, prostate and bladder cancer.5
Almost one
in five (18%) patients who were admitted to hospital for heart failure died within six months of their admission in 2018/19, rising to almost one quarter (24%) within a year. Nearly 10% of patients were also readmitted for the same cause within 90 days. Heart
Experts say the stark inequalities could be down to heart problems too often being seen as ‘a man’s disease’ and heart failure not being prioritised in the same manner as other disease areas, like cancer.
failure also has an emotional, social and economic impact on those who live with it, and the report finds that: l 43.8% of those surveyed agree their ability to work was negatively affected and 31.9% agree that their career development has been hindered due to the length of time it took to receive a final diagnosis, while 30.2% suffered financial losses.
l Almost half (46.9%) said their emotional wellbeing or mental health was impacted, rising to 54.1% among women.
l Asked about how the length of diagnosis
had impacted their relationships, 31.2% of patients agreed it had negatively impacted on their relationship with their children and wider family, 27.5% for their partner, wife or husband and 30.8% for friends.
Meanwhile, the impact of COVID-19 on heart failure patients has been particularly acute, with appointments and surgeries put on hold to mitigate the spread of coronavirus. The report finds: l 38.4% of patients surveyed had a hospital or GP appointment for heart failure cancelled during the COVID-19 pandemic, while over a third (33.4%) admitted they were avoiding going to the doctors to discuss the condition.
l Over a fifth (20.5%) of patients struggled to pick up their prescription for their heart failure medication and 18.9% said they’d had problems accessing their medication.
l 29.3% said their symptoms had got worse, while 36.8% agreed their quality of life had suffered.
l 43.7% of patients agreed their mental health had been negatively impacted as a result of living with heart failure during the COVID-19 pandemic.
The report calls for improved education on the signs and symptoms of heart failure in primary care, as well as easier access to tools to aid swift and accurate diagnosis in primary and secondary care. This includes more consistent use of NT-proBNP testing in hospitals, and ensuring CCGs are incentivised to commission and use diagnostic tools to improve early detection of heart failure. Professor Martin Cowie, professor of
cardiology, Imperial College London, and consultant cardiologist, Royal Brompton and Harefield NHS Foundation Trust, commented: “This new report highlights some major issues surrounding the diagnosis of heart failure in the NHS. In particular, there is a striking gender gap in the speed and accuracy of the diagnosis for women compared with men. Too often heart problems are seen as a man’s disease – and are not even considered in a woman. This needs to change. Thankfully, we have simple blood tests that can help point doctors in the right direction – with good evidence that this speeds up the time from symptoms first
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