Team leads fight against heart failure

Swansea Bay is set to lead the way in helping to reduce heart failure.

Morriston Hospital’s cardiac service is one of just five sites across the UK – and the only one in Wales - chosen by The British Society for Heart Failure (BHS) to pilot a scheme to combat the condition.

Pictured above: Dr Geraint Jenkins (front row centre) and the team.

The move comes as the organisation launched its 25in25 initiative, which aims to reduce mortality from heart failure, in the first year after diagnosis, by 25% in the next 25 years.

Over one million people in the UK have heart failure, and with people living longer, the number of heart failure patients is expected to grow by 200,000 new diagnoses each year.

Heart failure means that the heart is unable to pump blood around the body properly. It usually happens because the heart has become too weak or stiff.

Currently, in the UK, 80% of heart failure is diagnosed in hospital where 40% of people had symptoms that should have triggered an earlier assessment in primary care in the months prior.

An estimated 385,000 people are unknowingly living with heart failure resulting in thousands of lives being lost because the condition is not being detected.

Cardiology consultants Dr Geraint Jenkins, Dr Carey Edwards, Dr Ben Dicken and Dr Parin Shah, and their heart failure team, will now work alongside nurses, pharmacists, and GPs to raise awareness and help people take preventative steps before it is too late and they end up in hospital.

Welcoming the news, Dr Geraint Jenkins said: “The early identification of people who are at risk of heart failure, detection, access to tests, diagnosis and treatment is crucial to ensure we are doing our best to tackle the predicted exponential rise in heart failure and to help people have better access to care to live well for longer.”

He also heralded Morriston Hospital being chosen to take part in the initiative.

He said: “Across the UK, 16 sites applied and we have been chosen as one of just five to take part in this quality improvement initiative, prior to a national rollout.

“It's quite a big thing.

“We are clearly leading the way in heart failure and are on the map nationally, if not internationally.”

Dr Jenkins said that heart failure is very common as we get older.

Explaining the condition he said: “There is no easy definition of heart failure. Basically, it's a failure of the pump of the heart to deal with the full requirements of the body.

“People think of it as people dropping down dead, but it's not. It's essentially people getting breathless, filling up with fluid, being exercise intolerant, getting tired because, basically, the heart can't keep up.”

The appointment is seen as recognition for the hard work carried out by the health board of late in developing its heart failure services, both for outpatients and inpatients.

Dr Jenkins said: “The service has expanded massively, and the British Society for Heart Failure has recognised us as one of the leading services in the UK.

“They want us to be one of the five pilot sites to show the rest of the UK how we go about developing heart failure services, because we've done a lot of it already.

“The whole team has put a lot of work into the 25 in 25 application. The process was very lengthy. We spent hours and hours over it. Lots of people got involved. So it was it was great to hear the news.

“We've spent a lot of money in Morriston on heart failure over the course of five years.

“We've gone from me by myself to now having six consultants focussing on heart failure, and from having one nurse to having around 16 nurses.

“Our inpatient nursing service is led by Delyth Rucarean and the outpatient service by Lydia Mason.”

Dr Jenkins warned the hard work was yet to come.

“There's a lot of work to do. It's also about developing our own services, making sure that we've got the capacity to take on patients,” he said.

“However, our current service is nowhere near enough to meet the demands of the population going forward.”

Any investment in prevention is bound to save the health board money in the long term, he said.

Dr Jenkins added: “Identifying these people and putting them on treatment saves money as well as improving outcomes for patients in terms of symptoms and duration of life.

“The treatment is very cheap, but treating people in hospital for heart failure is very expensive and the outcomes are potentially far worse. Getting to them early and getting them on treatment is highly cost effective and will inevitably have better outcomes.

“It's a good spend to save initiative.”

Richard Evans, SBUHB Interim CEO, welcomed the announcement.

He said: “I’m extremely proud of what the team has achieved and that they have been chosen as one of the few units in the UK to pilot this important work.

“The service that they’ve developed is an enormous benefit to patients in alleviating symptoms and preventing deterioration.

“I’m looking forward to following their progress in the coming months.”

The three main objectives of the 25in25 programme are to make an early diagnosis, to improve patient outcome, and to detect undetected heart failure, perhaps those with no symptoms or patients whose diagnosis has been missed.

The initiative will focus initially on four areas:

• Education of the local population as well as health care providers – hospital doctors, GPs, nurses, pharmacists and the healthcare community that cross paths with heart failure patients and have the opportunity to identify them early.

• Making the service as accessible as possible.

• Developing specific pathways for specific groups of patients like the young being considered for transplantation.

• Detecting the undetected – working to find those heart failure patients who don’t have specific symptoms of heart failure but can have disease that would benefit from earlier treatment.