Ayrshire and Arran

Ayrshire and Arran Health Board

Service commenced

May 2004

Total board population


Urban / rural split

78% / 22%

Specialist HF nurse WTE posts

4 WTE (7 staff)

Further details

(Actual number of staff)2008 * 5 WTE (6 staff)
SIGN Ratio1:91,715 (2008 1:73,290)
Ave. caseload per post125 (community) / 225 (hospital)
Individual patients managed by service (average year)348 patients
Service ProvisionHome visits 80% / Clinic Appointments 20%
Provision for HF-PEFNo
Administration support per week18.75 hours (across service)
Providing education to non-specialist staffYes - informal basis to non-specialist staff
Doctor with specialist interest in Heart Failure1 Consultant Cardiologist (non-specialist)
Cardiac Rehabilitation available/number seenYes - 80 patients in total
Access to psychological support referral pathwayInadequate (currently recruiting to clinical post)

Notes on current service provision

Three full-time posts are based in the community to follow-up patients discharged from secondary care and four advanced specialist nurses are based within the acute setting; their posts also cover Chest Pain Assessment, outpatient Rapid Access Chest Pain clinics and Cardiac Rehabilitation. Most referrals are from secondary care, although 30 were also received direct from GPs.

Funding in comparison to 2008

The service is core funded by the NHS with adequate provision, although the previous BHF Post of Palliative Care Specialist Nurse did not receive ongoing funding. The service is undergoing a process of succession planning for the Specialist Nurse posts.


The service is facing rising caseloads and differing methods of management are predicted to be challenges for the future. A replacement lead for the established Clinical Psychology service is awaited.

Development opportunities

A new database was recently implemented within the service and the specialist nurses are leading on the implementation of the HF Bundle across the NHS Board. New projects currently include tele-monitoring and the administration of diuretics (through a BHF funded secondment for 2 years). A new ICD pathway is also in the process of being implemented which will have the potential to impact on patients and the service.