We have partnered with Brighton and Sussex University Hospitals to refine the use of a common blood test to detect heart failure in more patients as early as possible.
With record numbers of people going to hospital with heart failure in England, it’s vital to improve the accuracy of tests to treat the right patients at the right time, helping more people to better manage their symptoms and live fuller and longer lives.
Heart failure means that your heart is not pumping blood around your body as effectively as it should. For people with severe heart failure, everyday tasks like going upstairs or walking to the shops become impossible. Although there’s no cure for heart failure, you can stop your condition getting worse by taking your medication and living a healthy lifestyle.
NT pro-Brain Natriuretic Peptide (BNP) is a blood test used as the first step in diagnosing suspected heart failure. If a patient has a test result above a specified limit they will need to have an echocardiogram (an ultrasound scan of the heart) to confirm a heart failure diagnosis.
Targeting the right patients
Sarah Young, Nurse Consultant Cardiology at Brighton and Sussex University Hospitals, led an audit, supported by the BHF, which revealed patients were undergoing tests unnecessarily or not getting the echocardiogram they needed if the result was raised.
After discussing the findings with nurses, doctors and consultants, Sarah created a new simpler algorithm for how the test should be used more effectively to target higher risk patients. Reducing unnecessary blood tests and importantly, ensures the right patients undergo an echocardiogram.
While the NT pro-BNP pathway is not new, the audit demonstrates it is not always used appropriately – and there is a need to support clinical staff to use it most efficiently.
This improvement could cut costs and save patients avoidable trips to their GP. Over a six month period, the audit found unnecessary tests costed just one small area of the hospital around £1,600.
Sarah Young said: “What we want is for the right patients to get the right test at the right time, which will improve their care and treatment. Using these tests appropriately will not only save money, it will mean people that need an echocardiogram will be able to access this when needed.”
Improving test accuracy to treat people sooner
The number of people in England who have been admitted to hospital due to heart failure is on the rise, which means the use of NT pro-BNP and echocardiogram testing are likely to grow.
Several factors could be contributing to the rise in people living with heart failure, including an ageing and growing population, growing numbers of heart attack survivors and stubbornly high rates of people living with heart failure risk factors such as high blood pressure and diabetes.
Sally Hughes, our Head of Health Services Engagement, said: “Heart failure is still not being diagnosed early enough – that’s why we’re supporting new ways to ensure more people get diagnosed and treated as soon as possible.
“It’s early days, but if improvements like this yield earlier and more accurate heart failure diagnosis, we could provide treatment sooner for the estimated 920,000 people living with this often cruel and debilitating disease in the UK.”
Helping patients keep on top of their medications
Keeping track of many different medications to treat heart failure which is often one of a number of long term conditions that the patient has to manage can be difficult. We’re also supporting a project to ensure these patients take the right medication properly to help control their symptoms and reduce any unnecessary medications too.
The Brighton and Hove Clinical Commissioning Group linked pharmacists with the community heart failure specialist nursing team to create a new referral pathway for patients to have their medicines reviewed.
Clinically, it has already proven beneficial. From the first eight referrals the team received from the nurses, the pharmacists recommended 33 changes or interventions. They also stopped 12 unnecessary medications saving nearly £1,500, as well as potentially preventing two hospital admissions with the associated healthcare costs.
How we're improving heart failure diagnosis