46% / 54%
2 WTE (4 staff)
|(Actual number of staff)||2008 * 2 WTE (2 staff)|
|SIGN Ratio||1:182,473 (2008 1:179,429)|
|Ave. caseload per post||70 (community)|
|Individual patients managed by service (average year)||238 patients|
|Service Provision||Home visits 80% / Clinic Appointments 20%|
|Provision for HF-PEF||Yes – cardiologist referral with management plan in place|
|Administration support per week||9 hours (across service)|
|Providing education to non-specialist staff||Yes – 1 hour sessions to GP surgeries raising awareness of service pathway and refresher on heart failure management|
|Doctor with specialist interest in Heart Failure||1 Consultant Cardiologist (specialist interest)|
|Cardiac Rehabilitation available/number seen||Limited - no referral pathway|
|Access to psychological support referral pathway||Inadequate (waiting list of up to 6 months)|
In 2010, the service moved from management by the Acute Operating Division to within Primary Care. Service redesign is ongoing to ensure that the service is being utilised to maximum effect. An increase in telephone consultations and developing locality clinics allows us to continue to see patients close to their homes and cuts down time and money (mileage) spent travelling to home visits. By developing closer working relationships and sharing the more stable caseload with the vascular teams in the CHPs, the service can see more patients. A lot of work has been carried out to develop and implement the heart failure care bundle, with MCN support.
Core funded by NHS Fife.
Despite increasing demand, we are able to keep a manageable caseload by transferring the care of more stable patients to the vascular services in the CHPs. Our case load number does not reflect the true amount of referrals coming into and being discharged from the service.
We are opening referrals to other types of heart failure e.g. HF-PEF and inoperable valve problems (if referred by a cardiologist with a management plan). Widening the criteria has not overwhelmed the service and input from the service has reduced hospital admissions and improved the patient’s quality of life. We are participating in a 2 year Telehealth pilot and a multidisciplinary heart failure clinic for both new and existing referrals.