Legal right to 2 week review of patients with suspected heart failure (HF)

The 2010 NICE guidelines recommend that patients with suspected HF should be reviewed by a specialist - within 2 weeks for urgent cases. Patients are presently waiting up to 20 weeks for specialist assessment.

The Government should ensure that this recommended right to a review within 2 weeks is set out in law.

Many heart failure patients have poor outcomes, with 1-and 5-year mortality rates worse than some of the most common cancers.

In 2010 it became a legal right of NHS patients with suspected cancer to be seen by a hospital doctor within 2-weeks of a GP referral.

We request that NICE quality standards are implemented with the same vigour as they are in cancer, and for the government to legislate that high-risk patients with suspected heart failure are seen by a specialist within 2-weeks of referral.

The National Institute for Health and Care Excellence published guidance on the diagnosis and management of heart failure in 2018. It recommended that patients should receive a clinical examination and those with suspected heart failure should be reviewed urgently by a specialist and that transthoracic echocardiography be undertaken within 2 weeks of referral.

There are no plans to set out in law that patients should be reviewed by a specialist within 2 weeks of referral.

Heart Failure, along with other conditions associated with cardiovascular disease (CVD), are a key priority in the NHS Long Term Plan (LTP). One of the ambitions of the NHS LTP is to raise awareness of the symptoms of heart failure and to ensure early and rapid access to diagnostic tests and treatment.

To improve early detection of heart failure, NHS England and Improvement (NHSEI) is committed to increasing access to the brain natriuretic peptide (BNP) blood test and echocardiography, with early adopter sites testing clinical pathways in 2021. Greater access to echocardiography in primary care will improve the investigation of those with breathlessness, a key heart failure symptom.

In April 2020, the Quality and Outcomes Framework (QOF), which is an annual reward and incentive programme for GP surgeries in England, was updated to support moves towards earlier diagnosis and management. GP surgeries are asked to capture data to show they have fulfilled their QOF requirements, which encourages the earlier confirmation of heart failure diagnosis. This update also means that patients with heart failure can now expect to have an annual review.