1. Heart Failure Blueprint for Healthcare Professionals A comprehensive overview of the optimal heart failure pathway, structured across seven stages from case finding and diagnosis to ongoing management and palliative care. It includes data, best practice examples, and innovations from across health systems to support pathway redesign.
2. Improving the Heart Failure Pathway Through Quality Improvement: A How-To Guide A practical, step-by-step guide to help teams identify gaps, design solutions, and implement sustainable improvements using a structured quality improvement approach.

These guides are designed to:

• Support earlier diagnosis and intervention.
• Improve coordination across primary, community and secondary care.
• Enable adoption of evidence-based treatments and innovations.
• Reduce avoidable admissions and improve patient outcomes.
• Provide a practical ‘playbook’ for local transformation.

These resources are intended for multidisciplinary teams working across the pathway, including:

• Cardiologists, GPs and clinical leads.
• Nurses, pharmacists and allied health professionals.
• Service managers and commissioners.
• Quality improvement and transformation leads.

The guides can be used flexibly:

• As a complete programme to redesign your pathway end-to-end.
• To target specific challenges such as diagnosis or optimisation.
• As a facilitation tool for workshops and system-wide collaboration.
• Used together, they provide both the what (the blueprint) and the how (the improvement approach) to support meaningful and sustainable change.

• a heart disease calculator
• an AI-enabled ECG
• AI analysis of heart scans. 

Watch the webinars and find out more from the NIHR website.

In the interest of health, wellbeing, prosperity and fairness, the report recommends a three pronged approach to tackling CVD:

1. Supercharge prevention
2. Better condition management
3. More science, more innovation

• As of June 2023, there have been nearly 100,000 excess deaths in England involving CVD since the beginning of the pandemic.
• On average, there have been over 500 additional deaths a week involving CVD since the pandemic began.
• While deaths from Covid-19 have fallen year-on-year since the beginning of the pandemic, the number of deaths involving CVD have remained high above expected levels.
• Excess deaths involving CVD outnumber those involving all other individual disease areas since the beginning of the pandemic in England.

In light of these findings, the British Heart Foundation is calling on the Government to:

• make NHS heart care a priority.
• improve prevention of heart disease and stroke.
• invest in research for treatments and cures.

• The prevalence of cardiovascular disease in adults in England was 6.0%. The prevalence increased with age and males were more likely than females to have the disease
• Prescription of anticoagulation drug therapy, for those with AF at high-risk of stroke, increased by one percentage point since March 2021 to 88.9% in March 2022
• Nearly 20% of people with CVD did not have a recorded current prescription of lipid lowering therapy (secondary prevention).

• CVD is largely preventable. The risk factors for CVD apply also to other major conditions such as cancer, dementia and diabetes. Preventing and managing CVD and its risk factors therefore has the potential to improve population health, reduce health inequalities and ease pressures on overstretched health and care systems by reducing demand for services.
• The current national CVD policy landscape is fragmented. National leaders need urgently to deliver coherent CVD and public health strategies that focus on preventing and managing CVD and its risk factors.
• Given its high prevalence and large contribution to health inequalities, tackling CVD will be a relevant priority in most local areas. Integrated care systems (ICSs) can tackle CVD in their local areas by establishing strong local leadership and partnerships on CVD and public health, focusing on preventing and managing CVD and its risk factors, raising awareness of CVD, using data, tools and technology effectively, and reducing clinical variation.

There is a 30 minute Adjournment Debate at the end of each day's sitting of the House of Commons. They provide an opportunity for an individual backbench MP to raise an issue and receive a response from the relevant Minister. Unlike many other debates, these take place without a question which the House of Commons must then make a decision on.

Diagnosis of pulmonary embolisms

In this debate Helen Hayes, MP for Dulwich and West Norwood, outlined significant patient safety issues relating to misdiagnosis of pulmonary embolisms. She highlighted concerns raised by her constituent, Tim Edwards, relating to the premature death of his mother Jenny. His research has estimated that there was a minimum of 400 excess pulmonary embolism deaths across England from April 2021 to March 2022, and that that excess figure is attributable to cases that were missed.

She asked the Minister to agree to work with NHS England to commission a review of the data set out in a forthcoming report from Tim Edwards and the related concerns raised by the Royal College of Radiologists, with a view to ensuring that the rate of misdiagnosis of pulmonary embolism is greatly reduced.

1. Bystander Cardiopulmonary Resuscitation (CPR) Ongoing strategies are needed at a population level to ensure that people who sustain an OHCA are treated rapidly with high quality resuscitation, including defibrillation, through a co-ordinated network of accessible and identifiable public access devices.
2. Advance treatment plans When advance treatment plans are in place, they should be documented using a standard process (such as the ReSPECT form) to ensure that people receive treatments based on what matters to them and what is realistic. Effective communication between all parts of the healthcare system, including, primary care, community services, ambulance services and acute hospitals is then needed to ensure that appropriate decisions are made, irrespective of time or location.
3. Prediction of survival No single factor is accurate enough for clinical decision-making at the time of admission to hospital following an OHCA. Time is needed to ensure an accurate assessment of prognosis can be made. Neurological prognosis is particularly difficult to assess, and this should be delayed for at least 72 hours after return of spontaneous circulation.
4. Targeted temperature management Elevated temperature is common following an OHCA and is associated with a worse prognosis, but this can be improved by accurate, active temperature control. The current approach in clinical practice appears to be inconsistent and a more active approach is needed.
5. Rehabilitation Physical, neurological, cardiac and emotional impairment following an OHCA can all affect quality of survival, and patients benefit from targeted rehabilitation and support. In some areas of the UK there is no provision of these services. These gaps should be closed by local clinical teams and commissioners working together.

• One delay or more in the process of care was identified in 161/420 (38.3%) patients, with recognition, investigations and treatment being the most common.
• The primary treatment for PE is anticoagulation. It is imperative that this is started as soon as possible. Where there might be a delay to the diagnosis of acute PE anticoagulation should be commenced. In this study the case reviewers reported an avoidable delay in commencing treatment in 90/481 (18.7%) patients.
• Once PE has been diagnosed an assessment of PE severity needs to be undertaken in order to treat patients effectively. In 144/179 (80.4%) hospitals their PE policy/guideline included the assessment of PE severity.
• This severity assessment was based on a validated scoring system such as PESI or Hestia in 128/142 (90.1%) hospitals. Case reviewers found no evidence of a PE severity assessment in the majority of patients (436/483; 90.3%).
• Severe (massive) PE requires additional or alternative treatment. A guideline/protocol for the diagnosis and care of patients with PE
  was provided at 151/180 (83.9%) hospitals.
• Ambulatory care has recently become a recognised pathway for PE management in those patients with low-risk of adverse outcomes. An ambulatory care pathway was used for all or part of the patient journey in 77/474 (16.2%) patients in this study. Wide variation in the selection of patients for ambulatory care was observed, with some high-risk patients being selected on this pathway and low-risk patients not being considered for it, resulting in unnecessary hospital admissions.
• Patients should receive all the information they need to make an informed choice, particularly with respect to taking anticoagulation. Treating clinicians were unable to determine if the patient was given verbal or written information regarding PE in 336/600 (56.0%) instances and specific information/ education regarding PE was not routinely provided to patients at 55/167 (32.9%) hospitals.
• An outpatient follow-up was not routinely arranged following a PE diagnosis in 32/179 (17.9%) hospitals.