SHFNF 2025 Review of Heart Failure Nurse Services

Introduction

The Scottish Heart Failure Nurse Forum (SHFNF) is proud to launch the 2025 Review of Heart Failure Nurse Services in Scotland.

Marking our 20th anniversary, this review provides an in-depth look at the current landscape of heart failure nursing, workforce challenges, and service development opportunities. It highlights both the progress achieved since our last review in 2018 and the future priorities needed to deliver sustainable, equitable, and high-quality care.

Our aim is simple: to ensure that every person in Scotland living with heart failure has access to the right care, at the right time, delivered by highly skilled and supported specialist nurses.

What the Review Covers

The report is built around national survey data from all 14 Scottish territorial health boards and presents a comprehensive overview of heart failure nursing services. It captures:

  • Workforce trends and challenges – current staffing, education levels, and gaps in progression and succession planning.

  • Advanced practice and education – highlighting the role of postgraduate training, non-medical prescribing, and advanced nurse practitioner/clinical nurse specialist pathways.

  • Service delivery – how heart failure nurses are supporting inpatient, outpatient, and community care, including innovative models such as Hospital at Home.

  • Innovation and quality improvement – real-world projects demonstrating how nurse-led initiatives improve early diagnosis, patient outcomes, and access to care.

  • Equity and access – identifying variations across Scotland and making recommendations to ensure fairer access for all.

  • Core components of care – from guideline-directed therapy to patient education, cardiac rehabilitation, psychological support, and palliative integration.

  • Data and sustainability – the urgent need for robust infrastructure to evidence impact, monitor pressures, and guide planning.

Key Findings

  • Heart failure nursing services are highly skilled and central to care delivery, but remain under pressure due to increasing demand and workforce fragility.

  • Education and training are improving, but variation persists in access to postgraduate learning and advanced practice frameworks.

  • Innovative projects are driving change — including point-of-care NT-proBNP testing (earlier diagnosis), Hospital at Home collaboration (supporting patients and staff), and HFpEF service models (addressing inequity).

  • Core services are strong, but gaps remain in cardiac rehabilitation, psychological support, and early palliative integration.

  • Without urgent investment in workforce, infrastructure, and national data systems, the sustainability of services is at risk.

Calls to Action

The review identifies 10 national priorities to secure the future of heart failure nursing in Scotland, including:

  1. Expand the workforce to meet demand.

  2. Guarantee equitable education and career pathways for all heart failure nurses.

  3. Protect the core role of heart failure nursing in diagnosis, optimisation, education, and psychosocial care.

  4. Standardise access and reduce waiting times – every patient should be seen within four weeks.

  5. Strengthen MDT integration across all boards.

  6. Invest in national data infrastructure to evidence impact and drive improvement.

(See the full report for all ten recommendations.)

Video Series

To bring the review to life, we have developed a set of short films featuring nurse leaders and projects from across Scotland:

Explore the full playlist here

Why It Matters

Heart failure remains a major public health challenge, affecting growing numbers of people across Scotland. Specialist nursing is proven to reduce hospitalisations, optimise therapy, improve quality of life, and support patients and families through every stage of the condition.

This review is both a celebration of 20 years of excellence and a call for action to secure the future of heart failure nursing. By strengthening services, investing in education, and reducing inequities, we can deliver sustainable improvements for patients, nurses, and the wider NHS.

Get Involved

We invite patients, healthcare professionals, policymakers, and partners to engage with this review, share its findings, and work with us to deliver positive change.

Read the full report: SHFNF review 2025

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By following and sharing, you’ll help us raise awareness of heart failure nursing, highlight innovation across Scotland, and support our call for equitable, high-quality care for everyone living with heart failure.