The British Heart Foundation's free membership scheme for healthcare professionals working in cardiovascular disease, which celebrates excellence in care.
Heart failure is a clinical syndrome with symptoms such as fatigue, breathlessness and fluid retention arising from the heart’s inability to pump sufficient blood around the body. This disabling and distressing condition can have a major effect on the quality of life for patients and their families.
As the symptoms of heart failure worsen, fluid accumulates in the lower limbs and eventually in the abdomen. Oral diuretics may help reduce fluid retention, but as the disease progresses, or with acute episodes, they are often not enough to control symptoms.
In the current system, the patient will then usually need admission to hospital for IV diuretics treatment, typically involving a stay of several days or longer.
Heart failure patients who wish to die at home are often unable to stay at home due to the need for IV diuretics.
Heart failure admissions are predicted to continue to rise as the population ages.
UK health policy has been shifting towards care being provided as close to home as possible. This is driven by the priorities of improving quality of care, cost-effectiveness and patient demand.
BHF pilot schemes across the UK have demonstrated the significant role that heart failure specialist nurses (HFSNs) can have in enhancing outcomes for patients and reducing hospital admissions.
We funded a two-year project with 10 NHS organisations across the UK, in urban and rural areas. The aim was to assess whether funding a home- or community-based IV diuretics service is safe, clinically effective and cost effective, and to gauge reactions of patients and carers.
We supported HFSNs to develop and introduce community-based IV diuretics services as part of existing heart failure services.
An independent external evaluation was undertaken.
The findings and feedback showed the intervention was clinically safe, and cost effective, and well received by patients and their carers.
A clinical summary explaining the evidence behind delivering an intravenous diuretics service in a community setting, including an implementation proposal and calculated cost savings.
You can also read the evaluation report for the IV diuretics pilot [PDF] and learn more about the impact of the programme.
Our innovative pilot has been adopted by NICE guidance as a QIPP case study, demonstrating how this programme delivers best practice. The work has also featured in Nursing Times, which cites the benefits of adopting this service model.
As well as our CPD-accredited clinical summary publication, Treating heart failure patients in the community with IV diuretics, we have published a leaflet explaining Learning points for the successful introduction of IV diuretics in the community.
Read more on our evidence-based service innovation programmes.
Interested in setting up your own community-based IV diuretics service? Our Business Case Toolkit can help you develop the approach you need to obtain funding.
To speak to us about how you could adopt community-based IV diuretics services in your area, contact us today.
1 Conrad, N. et al (2017) Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals. The Lancet, Volume 391, Issue 10120, 572-580
2 Brightpurpose (2014). Evaluation of IV Diuretics Pilot for BHF. Final Report.