Healthcare leaders in Northern Ireland were told that people facing heart failure could benefit from palliative care earlier in their treatment, with integrated care providing potential greater savings to the NHS.
To mark World Heart Day on September 29, Dr Tracey McConnell, a Marie Curie Senior Research Fellow organised a conference funded by the Public Health Agency (PHA), held at Queen’s University Belfast (QUB), to highlight the benefits of integrating palliative care with heart failure services both for the person’s quality of life and for reducing hospital use.
Heart failure is a major cause of death in both men and women.
According to Northern Ireland Chest Heart & Stroke, approximately 20,300 people in Northern Ireland have been diagnosed with heart failure by their GP, with around 161 deaths per year and 6,391 hospital admissions per year.
In the UK it’s estimated that heart failure accounts for a total of one million inpatient bed days (2% of all NHS inpatient bed days), 5% of all emergency medical admissions to hospital, and healthcare costs of around £2 billion per year (2% of the total NHS budget) per year.
Dr McConnell and Prof Joanne Reid from the School of Nursing and Midwifery; Queen’s University Belfast co-led an NIHR funded project called PalliatHeartSynthesis aimed at understanding why integrating palliative care into heart failure management remains so difficult despite strong evidence of benefits for people living with heart failure, their families and carers.
Marie Curie supported the production of the project’s policy report which is available on the project website https://palliatheartsynthesis.co.uk/
The report provides targeted recommendations for healthcare providers on how best to integrate palliative care and heart failure services.
Integrating palliative care must be on the policy agenda.
This reorganisation of existing services makes better use of the resources we have while improving care for those living with heart failure, their families and carers.
Linda Cooper from Londonderry who was involved in the project spoke on behalf of carers at the conference. She cared for her father, Paddy Kelly, who died from Chronic Heart Failure in the summer of 2020. She believes that had her father had palliative care earlier, his last year of life could have been better.
“Dad always felt that his medication would eventually be balanced, and his symptoms would ease,” Linda told the conference. “If he and we had been better informed that his condition was palliative, then we would have had a better understanding of his prognosis and we would have had more realistic expectations.
“Dad wouldn’t have been waiting to ‘get better’ and could have lived his life with a different mental attitude and accepted his condition and symptoms more readily and looked for other ways to relieve his symptoms or to come to terms with their limitations.”
Heart failure patient John Burden, who also contributed to the research project, argued that heart failure by its very nature should be seen as palliative care.
“I’ve suffered from heart failure for 10 years now, having cardiovascular disease for about 25 years and I’m now 76. As heart failure is currently incurable and progressive, my treatment is necessarily palliative in the truest sense of the word.
“It’s vital to correct misunderstandings amongst healthcare professionals, patients and carers about the terms palliative care and heart failure, that it’s not just about end of life care, it’s more than that.”
Dr McConnell said: “The need for palliative care to be integrated with treatment for heart failure patients will bring improved care for patients and greater saving for our healthcare system. We must build greater awareness of this, not only amongst healthcare professionals but the public as well.”
She added that an integrated palliative care and heart failure service in Wales found an estimated average saving of at least £14,109.36 per referral. It estimated that overall the integrated service saved approximately £2.4 million over five years.
Prof Reid said: “Our patients and carers with lived experience of heart failure were integral members of the research team, whose expertise helped shape all outputs from this project, including our policy report, blogs, and animation summarising key recommendations.”
Dr Janet Diffin, Programme Manager, HSC R&D Division Public Health Agency said: “We are delighted to have provided support for the PalliatHeartSynthesis research dissemination event through the Public Health Agency’s HSC R&D Division Workshop and Conference funding scheme.
“The findings have informed a set of recommendations on ‘how to’ integrate palliative care and heart failure services which will directly benefit healthcare providers, higher education institutions, and policy makers, and ultimately, help achieve the goal of ensuring patients with heart failure have timely access to palliative care.”
Other speakers included Dr Andrew Kerr, Speciality Doctor, Cardiology and Dr Rachel Campbell, Consultant in Palliative Care, both from the South Eastern Health and Social Care Trust in Northern Ireland, and Yvonne Millerick, Caring Together Programme, Scotland.
The project website can be found at https://palliatheartsynthesis.co.uk/
Photo Caption: Yvonne Millerick, Caring Together Programme, Scotland (from left), with Professor Joanne Reid, QUB and Dr Tracey McConnell, Marie Curie Research Fellow