Forth Valley

Forth Valley region

Service commenced in December 1999.

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Patients per year


from 300 in 2012.

Urban / rural split


from 80% in 2012.

Total region population


from 293,386 in 2012.

Specialist HF nurse WTE posts

3.35 WTE (5 staff)

from 3 WTE, from 4 staff in 2012.

Service provision

2012 2018
HF post MI HF post MI
Valvular HF Valvular HF
Congenital HF Congenital HF
Palliative Care General palliative care and 1 HF specialised palliative care nurse - direct links to specialist care
Cardiac Rehabilitation for HF
Screening for psychological distress- no direct referrals to psychology

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

  • Implemented Heart failure MDT
  • Day case diuretic in Cardiology Day Unit, Participating in Heart Failure research
  • Smooth introduction for assessment of suitability for Entresto, device and arrhythmia MDT.
  • Increased use of and protocol for Subcutaneous Furosemide in the community
  • Access to Natriuretic peptide testing

Service challenges

  • Improved access to psychology service (when escalation required

Future improvements

  • To speed up the process of diagnosis of outpatients following Natriuretic peptide testing by GP with same day echo and review of patients with elevated Natriuretic peptide.
  • To undertake a scoping exercise with for HFpEF/Right sided HF patients.
  • To scope options for a heart failure inpatient unit.


The following details are from our 2012 report and may not reflect the current state of the Forth Valley Health Board.

Further details

(Actual number of staff)2008 - 3.2 WTE (4 staff)
SIGN Ratio1:97,795 (2008 1:89,392)
Ave. caseload per post140 (community and hospital)
Individual patients managed by service (average year)300 patients
Service ProvisionHome visits 20% / Clinic Appointments 80%
Provision for HF-PEFNo
Administration support per week30 hours (across service)
Providing education to non-specialist staffYes – Secondary care: individual and group teaching with staff nurses and healthcare assistants in cardiology wards and clinics; Primary care: create meetings
Doctor with specialist interest in Heart FailureYes - 1 Consultant
Cardiac Rehabilitation available/number seenYes - 50 patients per year
Access to psychological support referral pathwayAdequate

Notes on current service provision

Manage patients with LVSD and symptomatic Heart Failure. Referrals received from wards, Cardiology and other clinics, Open Access Echocardiography and General Practice. Actively discharge patients once optimised and stable; liaise with SNAHFS as appropriate.

Funding in comparison to 2008

Core funded by NHS Forth Valley


Only one nurse undertakes outreach visits for Forth Valley. Managing in-patient workload with out-patient clinics and unpredictability of help-line calls all stretches service provision. Increasingly complex patients, particularly those with significant renal dysfunction. Unable to respond to demand to review patients with HF-PEF.

Development opportunities

HF nurses, in conjunction with consultants, implement evidence- based medicine in patients admitted with decompensation using the HF bundle and a holistic approach incorporating discharge planning. Access to Day Medicine Unit for patients who require IV diuretics. Provide pre-op assessment and education for patients undergoing implantation of a cardio-defibrillator [ICD].