Shetland
Patients per year
100
from 120 in 2012.
Urban / rural split
0%
from 0% in 2012.
Total region population
23,200
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 |
|---|---|
| HFrEF | HFrEF |
| HFpEF | HFpEF |
| 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
REMINDER
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 Ratio | 1:44,800 (2008 1:72,390) |
| Ave. caseload per post | 100 (community/hospital) |
| Individual patients managed by service (average year) | 120 patients |
| Service Provision | Home visits 40% / Clinic Appointments 60% |
| Provision for HF-PEF | No |
| Administration support per week | None |
| Providing education to non-specialist staff | Yes – update available to all staff annually |
| Doctor with specialist interest in Heart Failure | Yes – Consultant Physician with heart failure interest |
| Cardiac Rehabilitation available/number seen | Yes - 20 per annum |
| Access to psychological support referral pathway | None |
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.
Challenges
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.