Orkney
Patients per year
0
from 0 in 2012.
Urban / rural split
34%
from 34% in 2012.
Total region population
22,000
from 20,110 in 2012.
Specialist HF nurse WTE posts
0 WTE (0 staff)
from 0 WTE, from 0 staff in 2012.
Service provision
| 2012 | 2018 |
|---|---|
| HFrEF | HFrEF |
| HFpEF | HFpEF |
| HF post MI | HF post MI |
| Valvular HF | Valvular HF |
| Congenital HF | Congenital HF |
| Palliative Care | Palliative Care |
| Cardiac Rehabilitation for HF | |
| Screening for psychological distress |
Service model
| 2012 | 2018 |
|---|---|
| Home | Home |
| Clinic | Clinic |
| In-pt education | In-pt education |
| In-pt management | In-pt management |
| GP surgery | GP surgery |
| Virtual | Virtual |
Additional notes
Service achievements
- NHS Orkney has recognised the need to develop HF services and has been trying to recruit with this development in mind
Service challenges
- While there is not a dedicated HF nurse service, a HF nurse specialist provides HF review and advice as part of her role as Cardiac Specialist Nurse NHSO tried unsuccessfully to recruit to a part time HF nurse post. NHSO is therefore reviewing HF care provision.
Future improvements
- The Cardiac Specialist Nurse role has recently been reviewed using a workload tool and there are plans underway to remove admin duties to allow time to provide an advisory role for heart failure.
REMINDER
The following details are from our 2012 report and may not reflect the current state of the Orkney Health Board.
Further details
| (Actual number of staff) | 2008 - 1 WTE (1 staff) |
| SIGN ratio | None (2008 1:19,770) |
| Ave. caseload per post | N/A |
| Individual patients managed by service (average year) | N/A |
| Service provision | N/A |
| Provision for HF-PEF | No |
| Administration support per week | 10 hours available |
| Providing education to non-specialist staff | Limited (on an as required basis, but limited capacity) |
| Doctor with specialist interest in Heart Failure | None |
| Cardiac Rehabilitation available/number seen | Yes - stable patients have access |
| Access to psychological support referral pathway | Adequate |
Notes on current service provision
The service successfully reduced all cause admissions for patients with heart failure between 2007-10, despite the postholder having to also cover the cardiac specialist nurse role. Due to the retirement of the cardiac nurse the workload was such that the community heart failure service was withdrawn.
Funding in comparison to 2008
Funding was not continued following initial BHF funded period.
Challenges
There is 1 x WTE Clinical Nurse Specialist, who is a Heart Failure Nurse Practitioner. Advice and inpatient review available on an as required basis, but once they are discharged, there is no capacity for a community caseload. Previous experience has shown that having one post within the service is unsustainable. There is no permanent Echocardiographer post on Orkney with the services relying on a locum for diagnostic echocardiograms.
Development opportunities
Business case in progress for a new post to support the Cardiac Specialist Nurse role and the Heart Failure Liaison Service