General practice nurses (GPNs) have a vital role to play in reducing heart failure mortality but more must be done to support specialist training, a panel of leading nurses has said.
A roundtable hosted by NHS England and the British Society for Heart Failure (BSHF) last week heard fresh calls for more funding and protected time to enable GPNs to help reduce mortality rates from heart failure.
This discussion was part of a series of three roundtables aiming to explore the role of GPNs in the BSHF’s ‘25in25’ ambition – which aims to reduce mortality from heart failure in the first year of diagnosis by 25% in the next 25 years.
Chair of the BSHF Nurse Forum, Poppy Brooks, said that it was ‘really important to try to reach out to general practice nursing’ as an early part of the ambition, due to their important role in public health and preventative care.
Meanwhile, Lynn Mackay-Thomas, chief executive of the BSHF, said GPNs were in a ‘prime position’ to reduce deaths due to heart failure, because of the number of appointments delivered in the community.
However, Ms Mackay-Thomas cautioned that over the 25 years of the ambition’s timeline, the UK would see ‘a massive increase in the ageing population’.
‘We don’t have the [secondary care] services, as I’m sure you’re all aware, to deal with that,’ warned Ms Mackay-Thompson. ‘So, we have to bring people in earlier and diagnose them earlier in order to be able to cope with the demand.’
Currently, data assessed by the BSHF found that 80% of patients with heart failure are first diagnosed during an acute hospital admission, despite the fact that the first symptoms of heart failure are usually present for up to six months prior to hospitalisation.
The roundtable agreed that GPNs must ‘make every appointment count’ by checking for common symptoms of heart failure, including fatigue and fluid retention.
Likewise, it was agreed that there was a ‘key role’ for general practice nurses in improving health literacy and the health inequalities that underlie risk of heart failure.
For instance, the panel discussed how primary care nurses are able to discuss medical information and lifestyle advice with patients to improve understanding of heart failure.
National primary care nursing lead for England, Louise Brady, told the panel that ‘the general public understand what a heart attack is, but they often don’t know what heart failure is’.
‘So, a lot of our work in general practice around prevention is actually health and digital literacy and dispelling some of the myths and narratives [around heart failure],’ she added.
Ms Brady also highlighted the importance of a having a ‘careers competency framework’ in place to further develop the skills of the nursing workforce, and to ensure that nurses are upskilled and trained to manage heart failure.
However, Sarah O’Donell, practice nurse and professional lead for general practice nursing at Leeds Community Healthcare NHS Trust, said that ‘the first step up that we need’ is to increase funding for primary care.
‘There is practically no funding whatsoever for general practice nurses and it is ridiculous,’ Ms O’Donell told the panel.
‘We can’t do this without the funding because the practices haven’t got enough money to fund all the nurses to go on these courses.’
Ms O’Donnell also called for GPs to release more time for nurses to undergo training as she said current workforce pressures meant limited opportunity for further education.