heart rhythmThe British Heart Foundation has called on the NHS to roll out a “safe and effective” at-home treatment for heart failure patients that would reduce the burden on families and the NHS. 

The call follows a successful pilot scheme led by the British Heart Foundation, which looked at 96 patients in 10 NHS organisations around the UK. The pilot aimed to investigate if intravenous (IV) diuretics could be delivered safely outside of hospital by specially trained heart failure nurses either in the person’s home or in a community setting close by.

Fluid retention is one of the most common symptoms of heart failure, diagnosed in about 550,000 people in the UK, although many more are thought to be affected.

Currently, when oral treatments to combat fluid retention (diuretics) stop working, many patients have traditionally needed to go into hospital so that they can be treated with IV therapy. The average stay for these patients is about 13 days and this treatment alone accounts for 2% of all NHS bed days.  A large percentage of heart failure patients in the UK will need IV diuretic treatment at some point in their illness.

The results supported treatment outside hospital, finding that it was safe and viable. The response from patients was overwhelmingly positive with 100% satisfaction from the people receiving the treatment and 93% satisfaction from carers. The project showed that, with specialised training, nurses could safely and effectively provide intravenous diuretics for patients, largely in the comfort of their own homes.

In total, 79% of participating patients avoided hospital admissions, saving 1,040 in-patient bed days and £162,740 for the NHS Trusts and health boards involved.

Catherine Kelly, Director of Prevention, Survival and Support at the British Heart Foundation, said: “IV diuretics is a ground-breaking initiative that has the potential to help hundreds of thousands of patients remain close to home rather than spending a cumulative two million bed days in hospital each year.

“This simple but effective change in service delivery shows that true innovation which transforms patients’ lives doesn’t always come in the form of a new drug treatment.  This innovation shows how something as simple as changing the location of treatment can improve clinical outcomes, improve people’s everyday lives by supporting them to remain at home and avoiding what is often a distressing unplanned hospital admission.”

Caroline Senior, who led the scheme at NHS Leeds Community Healthcare Trust, said: “When we started doing this project we took every possible step to ensure that the quality of the treatment we were providing was to the highest standard and comparable with what a patient would receive in hospital. The feedback we got from our patients and their families has been overwhelming and this one simple change in their treatment has had a profound impact on their quality of life. With training and investment from the NHS this has the potential to make a world of difference for heart failure patients across the UK.”