Transforming heart failure diagnosis: a call to action

Heart failure is among the most urgent health issues facing the country. Cases are projected to nearly double by 2040, placing an unprecedented burden on the NHS and requiring a fundamental rethinking of how we diagnose and treat the condition. In heart failure circles, both the growing prevalence and its historical impact are increasingly referred to as a "silent epidemic." Compared to other major conditions, awareness and urgency surrounding the issue simply do not reflect the size of the challenge facing the health service. Hospital admissions for heart failure, for example, now surpass those for the four most common cancers combined. 

But even more importantly, this "silent epidemic" highlights the large number of people currently living undetected with heart failure and not receiving timely treatment and rehabilitation. The British Heart Foundation estimates that around 385,000 individuals are living with the condition without diagnosis or treatment. Each of these patients faces the life-changing toll of long-term hospitalisation, a crisis that could be easily prevented through prompt diagnosis and timely treatment. 

At present the health service is not prepared to meet this challenge, both in dealing with the complexity and scale of the challenge. One area where this stands out is primary care. Early detection and timely treatment remain the single most powerful tool in managing the burden of heart failure. The NHS Long Term Plan stated that 80% of people with heart failure are diagnosed in hospital, even though 40% of those cases had symptoms that should have triggered an earlier assessment.