NHS data shows gap in care for heart failure patients

A new study published in a BMJ journal has found that inadequate screening in heart failure has cost the NHS an avoidable £21.5 million.

The investigation, which is the first of its kind, has identified the hidden costs due to under-managed but treatable iron deficiency (ID) and iron deficiency anaemia (IDA) from one-year data of around 80,000 people with heart failure.

The findings revealed that potentially a third of people with HF are not being screened for ID/IDA, with potentially debilitating effects on their quality of life. The data also revealed that those who have ID/IDA are more likely to be re-admitted to hospital within 30 days than those without ID, 95% of whom present as emergency admissions.

With an NHS deficit of £960 million reported for 2017/2018, hospital bed occupancy hitting an eight-year high in 2018, and a near 7% rise in emergency admissions to hospitals reported for 2018/19, correct management of these patients presents an "opportunity for cost-savings for an over-stretched healthcare system."

"Some evidence suggests that iron studies are conducted in less than 20% of heart failure patients admitted to NHS Trusts, which is not enough when you consider that 50% of these patients are likely to be iron deficient" commented Dr Rani Khatib, consultant pharmacist in Cardiology and Cardiovascular Research, Leeds Teaching Hospitals.

"The published data estimate an additional £21.5 million a year is being spent on managing co-morbid patients with heart failure and iron deficiency or iron deficiency anaemia, and this is based on the small proportion of those who were found from testing, so the true cost is likely to be much higher. There is a clear need to raise awareness about the growing evidence in this area and translate into practice accordingly."

Nearly one million people in the UK live with heart failure, of whom around 50% may also suffer from ID.

Across the NHS, there is a clear disparity in the care that patients with heart failure receive. In patients who were screened and treated for ID, data show that the amount of time they spent in hospital varied widely, with a difference of up to 18 bed days.

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