Orkney region

Service commenced in March 2007.

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Patients per year


from 0 in 2012.

Urban / rural split


from 34% in 2012.

Total region population


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
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.


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 ratioNone (2008 1:19,770)
Ave. caseload per postN/A
Individual patients managed by service (average year)N/A
Service provisionN/A
Provision for HF-PEFNo
Administration support per week10 hours available
Providing education to non-specialist staffLimited (on an as required basis, but limited capacity)
Doctor with specialist interest in Heart FailureNone
Cardiac Rehabilitation available/number seenYes - stable patients have access
Access to psychological support referral pathwayAdequate

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 Due to the retirement of the cardiac nurse the workload was such that the community heart failure service was withdrawn.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.


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