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Global lessons from deaths from heart failure in UK hospitals
  1. Lisa J Anderson1,
  2. Iain B Squire2,
  3. Martin R Cowie3
  1. 1 Cardiology Clinical Academic Group, St George’s University of London and St George’s University Hospital NHS Foundation Trust, London, UK
  2. 2 Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
  3. 3 National Heart and Lung Institute, Imperial College London, London, UK
  1. Correspondence to Dr Lisa J Anderson, Cardiology Clinical Academic Group, St George’s University of London and St George’s University Hospital NHS Trust, London SW17 0QT, UK; lisa.anderson{at}stgeorges.nhs.uk

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The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) has recently published a review of the care received by patients who died in UK hospitals following an admission with acute heart failure (HF).1 A sample of up to six adults who died during an admission to each hospital in the UK in 2016 was selected, with a total of 603 deaths being examined in detail by a multidisciplinary group of case reviewers. Various aspects of care, both organisational and clinical, were reviewed and graded as either good practice, room for improvement or less than satisfactory.

There were six principal recommendations, shown in the box 1.

Box 1

Principal recommendations of the NCEPOD review of HF deaths in UK hospitals1

  1. An acute HF clinical guideline should be available in all hospitals. Care should be in a specialist unit, with HF team review within 24 hours, a standard protocol for diagnosis including natriuretic peptide (NP) testing and echocardiography, and medication guidance for immediate treatment prior to specialist review.

  2. All HF patients should have access to a HF multidisciplinary team, including a cardiologist, specialist HF nurse, pharmacist, palliative care specialist and a member of the primary care team, with other services (including elderly care, clinical psychology, physio- or occupational therapists, cardiac rehabilitation) as appropriate.

  3. Serum NP should be included in the first set of blood tests in all patients with acute breathlessness who do not have a past diagnosis of HF.

  4. An echocardiogram should be performed for all patients with suspected AHF …

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