Cardiology
Transforming heart failure diagnosis: a call to action
With heart failure cases increasing rapidly, more support is needed for early detection and diagnosis in primary care, argues Chair of the Alliance for Heart Failure, Preeti Minhas.
Heart failure is among the most urgent health issues facing the country. Cases are projected to nearly double by 2040, placing an unprecedented burden on the NHS and requiring a fundamental rethinking of how we diagnose and treat the condition. In heart failure circles, both the growing prevalence and its historical impact are increasingly referred to as a “silent epidemic.” Compared to other major conditions, awareness and urgency surrounding the issue simply do not reflect the size of the challenge facing the health service. Hospital admissions for heart failure, for example, now surpass those for the four most common cancers combined. But even more importantly, this “silent epidemic” highlights the large number of people currently living undetected with heart failure and not receiving timely treatment and rehabilitation. The British Heart Foundation estimates that around 385,000 individuals are living with the condition without diagnosis or treatment. Each of these patients faces the life-changing toll of long-term hospitalisation, a crisis that could be easily prevented through prompt diagnosis and timely treatment. At present the health service is not prepared to meet this challenge, both in dealing with
the complexity and scale of the challenge. One area where this stands out is primary care. Early detection and timely treatment remain the single most powerful tool in managing the burden of heart failure. The NHS Long Term Plan stated that 80% of people with heart failure are diagnosed in hospital, even though 40% of those cases had symptoms that should have triggered an earlier assessment. The Alliance for Heart Failure is a coalition
of patient groups, charities, and life sciences companies working together to improve outcomes for heart failure patients. Over the past five years, we’ve focused on how to improve heart failure diagnosis and management in primary care. Despite challenges in the aftermath of the pandemic, we’ve found reasons to remain optimistic about the future of heart failure care. The system is already beginning to realise the benefits of integrating specialists with primary care professionals, leading to earlier diagnosis and better management of the condition in the community. The NHS is also increasingly receptive to patient and clinical insights when it comes to heart failure, ensuring this valuable experience influences policy decisions.
Later this year, we will publish a report based on our findings, highlighting best practices and initiatives that form the foundation of a modern heart failure service in primary care. What stood out when speaking to both patients and clinicians was the significant geographical variation in care. Often, switching hospitals within your local area can lead to a life-changing experience with better access to specialist input and treatment. Our upcoming report is a call to action to ensure that every patient receives this standard of care. We want to ensure policymakers, health leaders, and the Government recognise, and more widely support, these pockets of best practice and clinical excellence.
Demystifying the condition and encouraging a role for primary care For many years, heart failure has been seen as a complex condition best managed by specialists. Unlike cancer or other cardiovascular diseases, it has lacked a strong national advocacy story, especially one that emphasises the key role primary care professionals such as GPs, practice nurses, and pharmacists can play in timely diagnosis and treatment. Heart failure is easily misdiagnosed and
overlooked, with breathlessness, exhaustion and ankle swelling (BEAT) often put down to age, lifestyle and the presence of other comorbidities such as hypertension, kidney disease and diabetes. Patients themselves often associate the symptoms with the normal signs of ageing or pre-existing health conditions. But despite improvements, the pandemic
delayed the significant progress needed to reduce the time to diagnosis in primary care. A 2020 study1
found that heart failure with
preserved ejection fraction (HFpEF) - which makes up about half of all heart failure cases - was not routinely integrated into general practice. The condition was often poorly understood, rarely visible, and infrequently diagnosed in primary care settings. Despite this, primary care holds immense potential to identify and manage heart failure
September 2025 I
www.clinicalservicesjournal.com 71
t
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80
