Key Actions for Change
- Development of a systematic HF pathway – it is key that all service providers have a high index of suspicion for HF, check NTproBNP and can refer early to an agreed standardised pathway. Examples of HF pathways available in resource section.
- Local /PCN HF prevalence – it is important to understand the actual vs expected prevalence and to put plans in place to close the prevalence gap. This gap will be addressed by better coding and looking for patients who are currently undiagnosed with HF
- Data: The prevalence of HF for practice should be tracked over time and shared on a regular basis to ensure there is a focus on diagnosis and to demonstrate steady progress.
Areas of Interest
Suspected HF
- Early identification – Without early identification, HF will progress untreated, and patients will be at risk of advanced disease, hospitalisation and preventable premature death. Systematic approaches for early identification across the PCN will provide patients with the best chance of survival. Full e-learning modules available for multi-disciplinary team members across the PCN.
- NTproBNP – ensure NTproBNP is checked in patients with potential HF, and urgent referral to a specialist Heart failure clinic if NTproBNP raised above referral threshold (NICE NG 106).
- Echocardiography – It is important when a patient has been referred for Echo/clinical assessment. This should be aligned to local pathways.
Toolkit Resource 
- NICE NG106 Diagnostic pathway - Overview | Chronic heart failure in adults: diagnosis and management | Guidance | NICE
- E-learning education modules - e-lfh.org.uk - programmes - heart-failure-and-heart-valve-disease
- Best practice guidance - Excellance in heart failure toolkit
- Heart Failure Pathway – Heart Failure Pathway - Cheshire & Merseyside Health & Care Partnership - cheshireandmerseysidepartnership.co.uk
- Prevalence - Fingertips - Cardiovascular-disease-diabetes-kidney disease