Heart Failure (HF) is one of the major chronic diseases in Ireland today. It is estimated that up to 2% of the adult population in developed countries has HF, with the prevalence rising to >10% among those aged > 70 years. Because it is primarily a condition of older adults, mortality and morbidity remain high with HF, despite advances in diagnosis and therapy. HF is reported to account for 5% of all emergency medical admissions, of which 80% are patients > 65 years of age.

Current data suggest a 2% prevalence of symptomatic HF in the Irish population (rising to 10% in those > 75 years), with a further 2% having asymptomatic left ventricular systolic dysfunction at risk of progressing to symptomatic failure; over 10,000 new cases are diagnosed annually. Therefore HF is more common than most cancers and represents a major public health burden.

Economic evidence highlights that HF is a major drain on health care spending accounting for an estimated 2-4% of total healthcare budget based on data from the UK and the US.

HF essentially means the heart is not working well enough to meet the needs of the body and its prevalence continues to rise because of three major driving factors:

• The ageing population
• Improved survival post myocardial infarction
• Continuing difficulty managing cardio-metabolic diseases (obesity, hypertension, type 2 diabetes) in the general population

A growing body of data, from national and international sources, shows that integrated management programmes for HF, encompassing primary care and hospital services, can produce significant reductions in the need for hospitalisation and achieve better quality of life and outcomes for patients. Shared-care with multidisciplinary based approaches are indicated in achieving the most effective HF care outcomes.

The National Clinical Programme for Heart Failure

The NCP HF aims to reorganise the way HF patients are managed. Taking into consideration that the majority of people with HF are based in the community, the programme is taking an integrated approach with emphasis on care and support in the community. 

Aim to Improve the Quality of Life of Patients

Objectives

Access

• Every patient with symptoms of HF is diagnosed correctly and without delay

Quality           

• Every patient with HF is managed within a structured programme
• Implement targeted programme to prevent HF

Cost      

• Reduce recurrent admissions with additional impact on de novo admissions    
• Reduce length of stay

Solution Areas

• Provide ready access to patients on disease information
• Develop care pathways to facilitate patient triage
• Establish specialist hospital services for patients presenting with acute decompensated HF including programmatic post discharge follow up
• In the community, development of a rapid access diagnostic service for new onset HF
• Support general practice to accurately diagnose and manage heart failure patients in the community