A systematic review of existing primary care and community-based heart failure services, to develop a new model of care within Primary Care Networks: A study protocol
THE PROBLEM:
Care for patients with HF is traditionally provided within secondary-care integrated community heart-failure clinics where heart-failure specialist nurses (HFSNs) provide care in community clinics or patients’ homes. This model is not ideal because many patients prefer to seek HF care with their GP practice with which they are familiar. However, the quality of care provided in primary care is often variable and below the standard of care provided by HFSNs. Patients with HF often have co-existing comorbidities. As a result, holistic patient-centred care is required to tailor care plans meticulously. Hence, our belief that primary care is a much suitable healthcare tier compared to secondary care alone.
YOUR APPROACH:
We aim to conduct a systematic review of existing primary care and community-based heart failure services, to develop a new model of care within Primary Care Networks (PCN). The primary outcomes will be measuring improvement in HF outcomes of care, particularly in primary care settings. This includes examining the standard of care, the cost-effectiveness of primary care-based HF services, rehospitalisation rates and patient satisfaction.
THE LEARNING:
Current NICE guidance recommends bi-annual follow-up routine appointments for stable CHF patients. A substitution of HF care from secondary to primary care seems sustainable, far more cost-effective and geographically appealing for patients living nearby a PCN-providing service. However, the need for a solid primary care understanding of HF is of utmost importance for this transition to occur.
WHY IT MATTERS:
The management of chronic heart failure (CHF) comprises considerable costs accounting to 1-2% of all healthcare costs which are estimated to be around 1-2% of all healthcare costs. These costs are mainly attributed to long-lasting re-hospitalisation rates. These figures are subject to increase due to the nature of an ageing population, further increasing the pressures on the secondary care system as well as increasing the costs attributed to HF care.
Presenting author:
Abdullah Egiz, University of Central Lancashire – School of Medicine, amaegiz@uclan.ac.uk
Co-authors:
Dr Lucy Astle, University of Central Lancashire – School of Medicine, LAstle@uclan.ac.uk;
Abdullah Egiz, University of Central Lancashire – School of Medicine, amaegiz@uclan.ac.uk;
Dr Nicola Cooper-moss, University of Central Lancashire – School of Medicine, NCooper-moss1@uclan.ac.uk;
Prof Umesh Chauhan, Professor in Primary Care Medicine, Mackenzie institute for clinical research, University of Central Lancashire – School of Medicine, UChauhan@uclan.ac.uk;
Dr Harmony Otete, University of Central Lancashire – School of Medicine, HOtete@uclan.ac.uk