Development of an end-of-life care pathway for patients with advanced heart failure in a community setting

Abstract

Chronic heart failure affects around 750000 people per year in the UK. Despite the development of evidence-based treatments the 1-year survival rate is poorer than for many common cancers. Quality of life is poor, with breathlessness, peripheral oedema and fatigue being common symptoms. Through clinical audit a community heart failure nurse identified that the palliative care needs of patients with advanced heart failure were not being adequately addressed in his locality. A more cohesive way of managing these patients was required. Joint working between heart failure and palliative care clinicians as well as the development of an advanced heart failure shared care pathway and supporting tools resulted in patients with heart failure having improved access to palliative care, more of these patients dying in their preferred place of care, and the provision of a holistic heart failure service spanning referral to end of life. The impact of chronic heart failure on both individual patients and the NHS is considerable. With interdisciplinary and interorganisational collaboration, a new approach to managing patients with heart failure has been developed that has resulted in improved patient care.