LHCH improving care for heart failure patients
Wednesday, 5 February 2025
A new first-of-its-kind remote management model of care for patients with heart failure, is to be rolled out across the region by Liverpool Heart and Chest Hospital NHS Foundation Trust (LHCH).
The ‘hub and spoke’ model, using evidence-based digital solutions, is being launched by LHCH community teams across Knowsley, Chester, and Wirral from the end of January 2025 in a 6-month pilot. The project’s early outcomes align closely with NHS England’s approach to remote patient monitoring in transforming healthcare delivery.
Remote monitoring of heart failure patients with cardiac implantable electronic devices (CIEDs) in situ, recently received national support following an endorsement by the National Institute for Health and Care Excellence (NICE).
The new model of care at LHCH involves readings from patients’ CIEDs, such as cardiac resynchronisation therapy defibrillators or implantable cardioverter defibrillators, being monitored by HeartLogicTM – an algorithm-based technology from Boston Scientific – and now ADVANTICSTM ClearPath HeartLogic – a digital platform that automates alerts and optimises clinical workload management.
The technology accurately detects signs of worsening heart failure by monitoring, for example, an individual’s general activity, respiration and heart sounds, enabling clinicians to diagnose potential heart failure deterioration earlier and intervene prior to decompensation. This positively impacts patient care with improved efficiency and a potential reduction in cost.
As one of the country’s leading centres for heart failure management, and with patient demand continuing to increase, LHCH has used remote monitoring technology as its standard of care for selected heart failure patients for several years. This is done in via a multi-disciplinary team with cardiac diagnostics, heart failure nursing teams and pharmacists at LHCH and out in the community, and heart failure consultants.
In England, there were around 90,000 hospitalisations for heart failure in 2019/20, which makes it one of the leading causes of avoidable hospitalisation and the most common cause of admission in people aged over 65 years.
Heart failure happens when the left side of the heart doesn't fill properly with blood during the diastolic (filling) phase. This means the heart is unable to pump enough blood to meet the body’s needs.
It is estimated 25,000 people in England have a cardiac device that is compatible with heart algorithm technology, a proportion under the care of the clinical teams at LHCH.
Dr Jennifer Llewellyn, Consultant Cardiologist at LHCH, said:
“We have been working with Boston Scientific for many months to identify cardiac decompensation even before the patient experiences symptoms, with the technology able to provide significant advance notice and early warning signs of worsening heart failure. Rachel Goode, Heart Failure/Complex Device Lead Clinical Nurse Specialist, has been instrumental in leading this project, and her work on this means we are now able to expand into the community heart failure team.
“For our community teams in Knowsley, Chester and Wirral, it means they will have access to this data and will be able to manage their own patients locally, with additional clinician support where needed.
“Overall, the HeartLogicTM and ADVANTICSTM ClearPath HeartLogic technologies are supporting us not just in reducing the amount of time that a patient spends with heart failure alert signs, but also in reducing the average time it takes for us to manage these alerts.
“In addition, by being able to manage patients locally in their own community, it will reduce the number of patients needing to attend clinics at LHCH, thereby releasing capacity and reducing clinic time costs.”