The Scottish Government hopes that the new national ‘heart hub’ will ensure patients with advanced heart failure from throughout Scotland get access to potentially lifesaving treatment.
The Scottish National Advanced Heart Failure Strategy – launched today (apprpriately on Valentine’s Day) at the Golden Jubilee National Hospital, home of Scotland’s Advanced Heart Failure Service – will enhance the care and treatment of heart failure patients across the country.
The strategy identifies clear priorities including:
* improving access to specialist expertise through outreach arrangements to local hospitals and communities to ensure consistent, equitable, Scotland-wide referrals for those with the most advanced heart failure
* increasing the number of heart transplants
* enhancing the current Scottish mechanical heart service (Ventricular Assist Devices) at the Golden Jubilee National Hospital
Health Secretary Nicola Sturgeon said:-“This strategy will ensure that patients with advanced heart failure get access to expert advice and, where necessary, the most modern treatment available, regardless of where they live in Scotland.
“Heart transplants are a key part of this work and it’s vital that we drive up the number of them by both increasing the numbers on the Organ Donor Register and making best use of available organs.
“But ventricular assist devices – so-called artificial hearts – also have a valuable role to play and can buy patients the time they need until their own heart recovers or a transplant becomes available.
“Patients can be referred to the national service from throughout Scotland. Arrangements are also in place to provide outreach services, with plans being developed to trial a telehealth link to the Western Isles, supporting the heart failure service there. Heart failure affects around 100,000 people in Scotland and it’s important that they get the best possible care and treatment.”
Heather McIntyre, a mum-of-three from Airdrie, received a short term VAD in July when she became critically ill as the result of advanced heart failure. She said:-“When I came into the Golden Jubilee National Hospital I was suffering from multi-organ failure; my heart, kidneys and liver were all shutting down. I don’t remember much of what happened at the time but there is no doubt that the VAD saved my life as it allowed my own heart to rest and to fully recover.
“The care and dedication of the staff at the Scottish National Advanced Heart Failure Service is superb and I am delighted that other people will have the same opportunity as me as part of this new strategy.”
Jill Young, Chief Executive of the Golden Jubilee National Hospital, said:
“This strategy supports the Golden Jubilee and Scottish National Advanced Heart Failure Service to become a nationally and internationally recognised centre of excellence.
“By being at the forefront of new technology and techniques, we will ensure that patients receive the best possible care and outcomes. This is a development that will have a positive impact on the health of future generations.”
Ventricular Assist Devices (VADs) can be short or long term and help the failing heart by pumping blood around the body.
Short term VADs act as a bridge to either recovery, a heart transplant or a long term VAD. They can also be used to support a transplanted heart if it initially fails. Long term VADs can be used as a bridge to transplant or recovery (which can allow full organ recovery). The intention is that, once their clinical effectiveness is fully proven, they could be used as ‘destination’ therapy for patients who are not eligible for transplant.
While heart failure patients will continue to be managed locally in accordance with the Better Heart Disease and Stroke Action Plan, those with the most advanced disease will be referred to the national service if they need a transplant or VAD.
Dr John Payne, Consultant Cardiologist at the Scottish Advanced Heart Failure Service, said:
“The Advanced Heart Failure Service will ensure we support local health boards. This will be primarily by raising awareness and educating health professionals and providing clear referral guidelines. In addition, we will continue our role in providing advice to clinicians to improve care locally.
“By doing this we will have a consistent, equitable, Scotland-wide referral pathway for patients with advanced heart failure.”
While transplant activity is increasing overall, there are issues in relation to the number of donor hearts becoming available. Mr Udim NKere, Lead Transplant Surgeon at the Golden Jubilee, said:-“NHSScotland must make the best use of those organs that are donated. To do this our multi-disciplinary team have put in place a number of review and scrutiny mechanisms in relation to donation and implantation. These include arrangements for transporting hearts and better communication links with Intensive Care Units across Scotland.”
The Scottish National Advanced Heart Failure Service was established in 2006 to provide advanced treatment options including heart transplantation for patients who are both disabled and whose lives are threatened by heart failure despite all standard modern treatment.
The British Heart Foundation said that they welcome the publication of the strategy and the commitment that patients with advanced heart failure will have access to the advice and treatment they need. However, they believe that it is also vital that we maintain the highest standard of joined-up care at a local level.
The Prevention and Care Adviser at BHF Scotland, Andy Carver, said: “Increasing numbers of people are living with heart failure.
“Fifty years ago, an estimated 9,000 Scots had heart failure. But an ageing population and the fact more people now survive heart attacks mean more than 72,000 people now live with the condition and even higher numbers are expected in future.
“In these cash-strapped times, the Scottish Government and NHS boards need to ensure that people with heart failure can get access to specialist, nurse-led heart failure services in their own communities.
“These services improve quality of life for patients, reduce premature mortality and unnecessary hospital admissions.”
Photo of Nicola Sturgeon reproduced from The Scottish Government Flickr Photostream
