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Call to boost heart failure nursing
Urgent funding is needed to increase heart failure nurse numbers, education and expertise across NHS Scotland, finds a new review of services.
A review of heart failure nurse services in Scotland is calling on national and local healthcare leaders to urgently invest in the nursing workforce to meet rising demand.
The 2025 review by the Scottish Heart Failure Nurse Forum warns that rising numbers of increasingly complex heart failure cases mean the NHS must prioritise strengthening nurse numbers, education and expertise to ensure high-quality, patient-centred care can be delivered in the future.
In partnership with British Heart Foundation Scotland, the forum surveyed all of Scotland’s 14 health boards as part of its review.
Findings show rising hospitalisation rates for heart failure, with 2 health boards reporting admission rates of 35 per cent and 75 per cent above the national average.
On top of this, heart failure cases are becoming more complex due to the ageing population, delayed diagnoses, health inequalities, frequent admissions and poor prognoses.
However, despite evidence showing nurse-led heart failure care reduces hospitalisations and improves survival and quality of life, the review finds there has been no net growth in the workforce for five years.
For heart failure nursing services to be fit for purpose in the future, the review calls for urgent action in 7 areas:
- Expand the workforce to meet rising patient numbers and increasing care complexity.
- Ensure equal access to education at Master’s level, protected CPD time, clinical supervision, participation in quality improvement and research, and clear career progression frameworks for specialist heart failure nurses in line with Advanced Nurse Practitioners.
- Prioritise interventions that improve patient outcomes, such as timely treatment, clinical review, patient education, self-care support and psychosocial care.
- Boost non-medical prescribing and enable the full use of prescribing to optimise therapy, reduce delays and promote self-management. Plus, ensure every patient receives their first specialist nurse contact within 2 weeks of referral.
- Staff multidisciplinary teams at every service, including access to a consultant with heart failure expertise, alongside pharmacists, physiotherapists, palliative care specialists and other multidisciplinary team colleagues.
- Develop a national data infrastructure to enable real-time monitoring, outcome reporting and benchmarking. This should be supported by funding for admin and digital systemsto aid audit participation and informed service planning.
- Maximise clinical time and expertise by providing appropriate admin and data entry support, while integrating holistic care skills across the heart failure pathway–from inpatient care through to cardiology and primary care.
Read the full report: The 2025 Review of Heart Failure Nurse Services in Scotland: Why this Matters
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