Postcode lottery for UK heart failure patients, researchers find

Postcode lottery for UK heart failure patients: 15% of NHS units dedicated to treating the killer condition aren’t led by specialists despite guidelines saying they should be

  • Differences between heart failure services in Britain are ‘stark’
  • In the best performing services, a patient may be cared for by seven nurses
  • The worst services don’t even have a specialist or admin staff for paperwork
  • Guidelines for care were updated in September but have not been met 

Heart failure patients across the UK face a ‘postcode lottery’ in the NHS care they receive, according to a report.

Researchers uncovered a ‘worrying wide variation’ and ‘lack of consistency’ in the level of care received across the home nations. 

The British Heart Foundation described the differences as being ‘stark’ – the worst-performing regions were not named.

Health watchdog NICE updated its guidelines for the treatment of chronic heart failure nine months ago. 

The body said hospital units for people with chronic heart failure should include a specialist trained in the condition, such as a cardiologist.  

However, a survey of nearly 80 health providers in the UK found one in seven services have no such doctor.

Heart failure patients face a ‘postcode lottery’ in health care as hospitals across the UK are not meeting recommended care standards, according to a report by the British Heart Foundation [File photo]

In a quarter of the services, people with heart failure are cared for by just one or two nurses.

The study, led by pharmaceutical giant Novartis, found the best-served providers had more than seven nurses.  

A total of 24 had no admin staff – forcing doctors and nurses to spend time doing paperwork rather than treating patients. 

The study, led by Novartis’ heart failure expert Helena Master, were presented at the British Cardiovascular Society Conference in Manchester.  

Ms Masters said: ‘These findings show that there is a worrying lack of consistency in heart failure services provided across the UK.

‘Around one in seven of the services surveyed don’t have either a consultant or a lead physician who specialises in heart failure.’

She said this highlighted ‘a concerning deficit’ between NICE recommendations and clinical practice.

‘With ever increasing numbers of heart failure patients, it is important each area of the country has the resources to improve and extend the quality of life of people living with this debilitating condition,’ Ms Masters added.

‘There are innovative and effective treatments for heart failure, so it’s vital that patients are diagnosed early and have access to specialist care.’

Figures suggest there are around 900,000 Britons who live with heart failure, which raises the risk of stroke and further heart problems.

Data was provided by 67 trusts and one social enterprise in England, five health boards in Scotland, four in Wales and two in Northern Ireland.

Each covered an average population of 600,000 with 1,600 heart failure patients. The highest service cared for 20,000.   

Professor Metin Avkiran, associate medical director at the BHF, said: ‘This is a long-term condition that often gets worse over time.

‘As well as the day-to-day challenges, people with heart failure are more likely to suffer a stroke and late-stage heart failure has very poor survival.

‘As more and more people can expect to survive a heart attack, there are a growing number of people at risk of developing heart failure later in life.

‘We need to have the right services in place to physically and mentally support them.’ 

Heart failure patients can find everyday tasks like dressing themselves or climbing the stairs exhausting.


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

Heart failure doesn’t mean your heart has stopped working – it just needs some support to help it work better. It can occur at any age, but is most common in older people.

Heart failure is a long-term condition that tends to get gradually worse over time. It can’t usually be cured, but the symptoms can often be controlled for many years.

The main symptoms of heart failure are:

  • breathlessness after activity or at rest
  • feeling tired most of the time and finding exercise exhausting
  • swollen ankles and legs

Some people also experience other symptoms, such as a persistent cough, a fast heart rate, and dizziness.

Symptoms can develop quickly (acute heart failure) or gradually over weeks or months (chronic heart failure).

See your GP if you experience persistent or gradually worsening symptoms of heart failure.

Source: NHS 

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