IT is a common expression in response to a nasty shock: "Don't give me heart failure." And yet many misunderstand this admittedly misleading term.
Rather than denoting someone whose heart has stopped beating, it is the label for what happens when the heart carries on beating but its action is impaired, preventing blood and oxygen from reaching the extremities of the body. It produces fatigue, breathlessness, discomfort and swollen hands and feet. It can be a disabling, frustrating and isolating condition, especially for those who live alone.
The number in Scotland with heart failure is rising steadily. That is not only because the population is ageing but also because far more people are surviving heart attacks. In itself this is a cause for celebration. Consultant cardiologists no longer have dozens of patients on their waiting lists who die before their first appointments. However, it leaves large numbers of patients – currently around 94,000 in Scotland alone – with hearts that are permanently damaged and weakened.
The quality of life and life prospects of someone with heart failure can be improved dramatically by specialist nursing. Scotland's first heart failure nurses were funded by the British Heart Foundation. Their monitoring, support and advice meant not only a better quality of life for patients but far fewer ended up back in hospital. As a consequence, the NHS funds all such posts in Scotland.
However, as The Herald reports today, the number of specialist heart failure nurses is falling as the number of patients with heart failure rises. The number of full-time equivalents has dropped from 51 to around 47 since 2008. And only 3% of patients with heart failure are getting cardiac rehabilitation.
Scotland falls short of the recommended minimum of one such specialist nurse to every 100,000 population. (Orkney has none at all.)
This is a false economy as it has been calculated that these nurses save an estimated £1826 per patient, because of a reduction of more than one-third in hospital admissions. That is why last year the Scottish Parliament Public Audit Committee report requested "clarification from the Scottish Government on the future plans for heart failure nurses across Scotland".
These nurses offer NHS Scotland a win-win situation: patients lives improved and money saved. These patient numbers are bound to increase, necessitating a national approach to planning specialist services, combined with adequate resourcing. Rather than crying "Don't give me heart failure", heart attack survivors should be saying; "Do give me a heart failure nurse."
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