Patients face six-year wait for test after first signs of heart failure
New research has found that people can wait up to six years to be tested for heart failure after first presenting with key warning signs, due partly to delayed symptom recognition and a lack of testing in primary care.
Measuring natriuretic peptide (NT-proBNP) levels via a simple blood test can help diagnose heart failure or rapidly rule it out, and is recommended by NICE. These tests can prevent people waiting for an unnecessary echocardiogram, reducing the burden on secondary care.
However, a new report by Public Policy Projects, commissioned by Roche Diagnostics UK & Ireland, found that NT-proBNP testing is used with less than a fifth of heart failure patients in England. Common symptoms of heart failure include breathlessness, fatigue and ankle swelling. 70 per cent of patients diagnosed with heart failure report fatigue, yet the analysis showed patients with fatigue wait six years for an NT-proBNP test after visiting their GP. For someone going with shortness of breath, the wait is two years, while for patients presenting with swollen ankles the wait is five years.
As a result, the research found that 80 per cent of heart failure cases are diagnosed following an emergency admission to hospital, despite 40 per cent of patients presenting with symptoms that should have triggered an earlier assessment in primary care. As one of the key symptoms of heart failure, it’s important that patients reporting breathlessness to their GP receive an NT-proBNP test to support the early identification of patients with potential heart failure.
The report, Breaking the Cycle of Late Diagnosis, also highlighted significant regional variations in outcomes for heart failure patients across the country. Following a heart failure diagnosis, on average people in the most deprived areas of England die six months earlier than those in the least deprived areas.
Heart failure affects nearly one million people in the UK, making it one of the leading causes of illness and death. Early and accurate diagnosis is critical to ensuring people with heart failure can access treatment to help manage their symptoms, improve their quality of life and reduce the risk of long-term complications.
Heart failure charity The Pumping Marvellous Foundation and Roche Diagnostics UK&I are calling for mandated NT-proBNP testing in primary care and for greater public awareness of the signs and symptoms of heart failure to drive earlier diagnosis. The Pumping Marvellous Foundation has launched their BEAT symptom checker to help people better identify potential symptoms of heart failure and know when to visit their GP – breathlessness; fatigue; ankle swelling; time for a simple blood test.
Nick Hartshorne-Evans, Heart Failure patient, Founder and CEO at The Pumping Marvellous Foundation, said: “It’s extremely concerning that patients are having to wait years after their first symptoms before being tested for heart failure – showing just how poorly recognised symptoms are. Every patient should have access to timely diagnosis. One simple blood test is the vital first step in ensuring the condition can be managed appropriately, allowing people to live better with their heart failure and helping alleviate avoidable pressures on the NHS. We must break the cycle of late diagnosis for heart failure.”
Ashton Harper, Head of Medical Affairs of Roche Diagnostics UK&I said: “People living with heart failure are facing a concerning cycle of delayed diagnosis, poorer outcomes, and an increasingly pressured healthcare service which keeps the cycle spinning. Paired with social determinants, this report highlights that the cost is very real and measured in months of a person’s life. It’s critical that we work together to take action to improve the early diagnosis of heart failure and break the cycle.”
Dr Clare Taylor, Heart Failure researcher and GP said: “Tackling the late diagnosis of heart failure should be a collaborative effort, with healthcare professionals from primary and secondary care working together to ensure patients have access to the care that can improve and extend their lives. Getting a timely heart failure diagnosis is the first crucial step.”