Key Actions for Change
- Review all patients prescribed ACEi/ARB/ARNI, BB, MRA, SGLTi or loop diuretics without a HF diagnosis: review the case notes and where appropriate, ensure they have codes for HF, the type of HF, and date of the echocardiogram.
- Review previous echocardiograms: to ensure key clinical findings are coded appropriately e.g. type of HF, valve disease and other important features.
- Put systems in place: to ensure all future cases of HF, HF subtypes and echocardiogram findings are coded.
- High Blood Pressure Locality Data: A British Heart Foundation Resource for All Primary Care Staff.
Areas of Interest
Diagnosed HF Optimising Coding Process
- Code cleansing of HF – Patients with known HF who are not coded in the primary care record often become lost to follow-up and have higher risks of complications. A systematic mechanism to register, recall and review patients with HF is essential.
- Patients with confirmed HF on Echo will need to be coded on the GP EPR. They will then need to be put on a recall and review system at the practice to ensure care is optimised (aligned to the care plan from the specialist/service or their holistic plan if have frailty or are in the last year of life), and that patients are educated around HF. There should be a holistic approach to co-morbidity optimisation, lifestyle care, outpatient monitoring in primary/secondary care, up-titration of meds, drug adherence, advance care plan etc
Toolkit Resource 
- NICE NG106 Diagnostic pathway - Overview | Chronic heart failure in adults: diagnosis and management | Guidance | NICE
- Tools to support primary care with coding - Nottingham University - Primis - Tools
- Oxford AHSN toolkit - Excellence in heart failure toolkit
- Society of Heart Failure Guidelines - Excellence in heart failure toolkit