Heart failure (HF) is a deadly and disabling cardiovascular disease with high rates of hospital admission and mortality worse than some cancers. There is an evolving heart failure crisis in Ireland due to the aging population and survival from previously fatal events. It is estimated that 80,000 people are currently affected in Ireland and a further 80,000 have impaired left ventricular function or impending heart failure. However with a structured approach to HF care hospital length of stay, readmissions and patient quality of life and longevity can be significantly improved.

SPIRIT Heart Failure Programme

In 2006 a three-year shared-care, I.T. interactive, collaborative heart failure management pilot, involving St Vincent’s University Hospital and 50 GP practices, covering a patient population of approximately 200,000 commenced with funding from HSE.  This initiative proposes to help GPs through a shared care programme with the St. Vincent’s hospital heart failure unit to identify patients earlier, achieve more accurate and timely diagnosis, minimise error, implement the evidenced base systematically and reduce hospitalisations and Emergency Room use while improving quality of life for patients.  

The aims of the project are to identify new-onset stable heart failure in the community before primary hospitalisation is required. To reduce the incidence of primary and secondary admission for heart failure by early diagnosis and collaborative, shared care, IT-facilitated management of all stable heart failure in the community setting and to improve application of evidence based medical therapy in the early management of heart failure

New service developments in heart failure

In 2007 the heart health programme was successful in getting funding and WTEs to improve HF services. A plan to target a number of sites throughout the country was developed in the following areas: support for the Chronic Disease Management patient support programme pilot by enhancing hospital and community outreach at the Mater hospital and St Luke’s hospital, Kilkenny  (HSE Dublin NE and HSE South).  Initiation of new service in Cork University Hospital and the early commencement of services in St James Hospital and Beaumont Hospital (HSE South, HSE Dublin ML and HSE Dublin NE).  Extension of the HF service in Cavan, Louth, Meath and Monaghan areas,to allow development of the community service (HSE Dublin NE).  Support for community based HF service in East Galway/West Midlands  (HSE West)

Heart Failure Action Plan

Following the audit,Ireland:Take Heart, a national action plan for heart failure 2008-2011 is being developed in order to improve quality of life and health outcomes, from early detection to terminal care, for people affected by or at risk of developing heart failure.

A steering group has been set up, chaired by Dr David Weakliam, Consultant in Public Health Medicine.