Shetland region

Service commenced in June 2005.

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Patients per year


from 120 in 2012.

Urban / rural split


from 0% in 2012.

Total region population


from 22,400 in 2012.

Specialist HF nurse WTE posts

0.5 WTE (1 staff)

from 0.5 WTE, from 1 staff in 2012.

Service provision

2012 2018
HF post MI HF post MI
Valvular HF Valvular HF (only with LVSD)
Congenital HF Congenital HF
Palliative Care Palliative Care
Cardiac rehabilitation Cardiac rehabilitation for HF
Screening for psychological distress with pathway to mental health services

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

Additional notes

The cardiac nurse specialist in addition to the HF service, covers Cardiac Rehab, Treadmill testing, Chair of CHD MCN, strategic and local service work and manages the Specialist Nursing Team

Service achievements

  • A locum Consultant Cardiologist has been in post since 2017 leading to improved access and continuity for patients.
  • The introduction of clinical pathways for Primary Care referrals

Service challenges

  • No cardiac physiologist in post – locum cover + NHS Grampian support

Future improvements

  • Introduction of a seated exercise class for HF pts/less able cardiac patients in April 2019
  • Introduction of a weekly health education sessions + “Drop in Cafe” for cardiac patients (including HF pts) to access – May 2019


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

Further details

(Actual number of staff)2008 - 0.3 WTE (1 staff)
SIGN Ratio1:44,800 (2008 1:72,390)
Ave. caseload per post100 (community/hospital)
Individual patients managed by service (average year)120 patients
Service ProvisionHome visits 40% / Clinic Appointments 60%
Provision for HF-PEFNo
Administration support per weekNone
Providing education to non-specialist staffYes – update available to all staff annually
Doctor with specialist interest in Heart FailureYes – Consultant Physician with heart failure interest
Cardiac Rehabilitation available/number seenYes - 20 per annum
Access to psychological support referral pathwayNone

Notes on current service provision

Challenging rural area with one half-time post covering the service.

Funding in comparison to 2008

Core funded by NHS Shetland.


Post-holder also has roles within Cardiac Rehabilitation, Rapid Access Chest Pain service, service development and work with the Managed Clinical Network.

Development opportunities

Open access has been established for patients with heart failure within the cardiac rehabilitation service and active management of the end of life for heart failure and palliative care links is in place.