Heart failure patients are dying or becoming seriously ill because of severe delays in NHS treatment, experts have warned.
It’s feared hundreds or possibly thousands of deaths and hospital admissions every year are occurring among patients waiting a year or more to see a specialist. Many could be prevented if tests and drugs were given sooner.
A new study shows most patients who see their GP with heart failure symptoms, such as breathlessness, extreme fatigue and swollen ankles, wait at least a year to get a diagnosis from a cardiologist.
Although heart failure is not curable, cardiologists can prescribe a variety of vital medicines that prolong survival and significantly improve quality of life.
The most effective of these – known as SGLT2 inhibitors – can slash the risk of being admitted to hospital with heart failure by more than 30 per cent.
But treatment guidelines bar NHS GPs from prescribing the drugs for heart failure, even though they can dish them out for other conditions such as diabetes and kidney disease.
Hundreds or even thousands of deaths and hospital admissions are occurring among patients waiting over a year to see a specialist
Critics claim that, as a result, patients are ending up in hospital seriously ill or dying while waiting to see a specialist.
Researchers behind the findings, based on a study of more than 8,000 patients, branded the delays ‘a scandal’ and called for an immediate shake-up in the way suspected heart-failure cases are handled.
‘We regularly see patients dying while on the waiting list for a cardiologist,’ said Dr Lisa Anderson, one of the researchers and a heart failure specialist at St George’s University Hospitals NHS Foundation Trust in London.
‘Many also end up seriously ill in hospital. Of those, 40 per cent die from their heart failure within a year. These patients are waiting far too long to see a specialist.’
More than a million people in the UK have heart failure, with 200,000 new cases diagnosed each year, according to the British Heart Foundation. It develops when the heart becomes too weak to efficiently pump oxygen-rich blood round the body.
It is common in heart-attack survivors, but it can also be brought on by high blood pressure, faulty heart valves, diabetes and even sleep apnoea.
The Health Foundation charity predicts that, with an ageing population and rising obesity levels, the numbers are set to double to two million by 2040.
People who go to see their GP with worrying symptoms are meant to have a blood test to measure levels of a protein called brain natriuretic peptide (BNP) which is made by the heart and blood vessels. Levels in those with heart failure are usually much higher than normal.
If their levels are extremely high, GPs are meant to fast-track a referral so patients are seen by a specialist within two weeks. A cardiologist may then put them on drugs, including SGLT2 inhibitors, to boost the heart’s pumping efficiency. But Dr Anderson says many GPs fail to carry out the tests or, if they do and the BNP level is raised, they don’t make the rapid referral.
The new study, presented last week at a heart failure conference in Lisbon, looked at data on 8,000 patients from Sweden. It found that more than two-thirds of those with raised BNP levels and symptoms of heart failure still had no firm diagnosis or the right drug treatment a year after first going to the doctor.
Although it’s Swedish data, UK researchers said the study reflects what’s happening here, too.
Dr Antoni Bayes-Genis, another of the researchers and a leading heart specialist in Spain, told the conference: ‘It’s a scandal. Patients go to their GP, get tested for BNP and nothing happens. There are a huge number of deaths that could probably be prevented.’
More than a million people in the UK have heart failure, with 200,000 new cases diagnosed each year, according to the British Heart Foundation
The findings mirror those of a recent probe by doctors at a surgery in East London which followed 77 patients with symptoms of heart failure.
Although 72 per cent had worrying BNP levels, the average wait to see a cardiologist was six months or more. Researchers warned: ‘This puts patients at risk. We need a national screening programme for it in primary care.’
One Mail on Sunday reader in his 70s wrote in earlier this month to say he was shocked to discover during a routine health check that his BNP levels were raised.
‘Now I have been given an appointment to speak to a cardiologist on the phone… in mid-October,’ he said. ‘Am I being overly concerned that my interests are not being properly addressed, or is this type of “treatment” normal in a post-Covid world?’
It’s estimated that some 100,000 patients a year in the UK end up needing emergency hospital treatment for heart failure, at least partly due to cardiology delays.
Dr Anderson and her colleagues at St George’s are now seeking funding for a trial to see if getting patients on to SGLT2 inhibitors sooner will improve their chances of survival.
- Have you been left waiting for a heart failure assessment? Write to health@mailonsunday.co.uk.
