Background This project was part of an Astra Zeneca pathway transformation programme aimed at improving the whole person approach to heart failure across Somerset. Research demonstrates that this patient group have significant unmet palliative care needs (Hospice UK, 2017).
Aims To explore and develop an equitable, supportive and palliative approach for people with heart failure that can be integrated into heart failure care (Sobanski, Alt-Epping, Currow, et al., 2020. Cardiovasc Res. 116: 12) in Somerset.
Methods A Task and Finish group was created with county-wide representation to ensure all organisations and potentially interested parties were involved. Time frames were agreed. There was scoping of what support and resources are available presently. Attendees were invited to contribute thoughts and ideas.
Two medical sessions per week were made available to support the project.
Education: symptom control and advance care planning were identified as priorities (Hill, Prager Geller, Baruah, et al, 2020. Eur J Heart Fail. 22:2327); both for health care professionals and carers.
Improved integration across heart failure and palliative care teams.
Development of a county-wide guideline.
To consider if subcutaneous furosemide could be given to patients in the community; success with this has been reported elsewhere (Birch, Boam, Parsons, et al., 2021. BMJ Support Palliat Care.; Brown, Robson, Armstrong, et al., 2019. Future Healthc J. 6:19).
ObjectivesProgress so far:
Education; sessions delivered to GPs, community and hospital nursing staff. A patient information leaflet is in progress.
‘Mini-MDT’ meetings have been set up on both sides of the county.
Guideline document created and available to a range of healthcare professionals.
Pilot subcutaneous furosemide project designed; scheduled to begin September 2022.
Conclusion By creating a Task and Finish Group with clear aims and engaged participation, much can be achieved within a specific timeframe. This project will enhance support for heart failure patients at the end of life and support integration of services across the county.
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