TY - JOUR T1 - Diagnosis and management of patients with heart failure in England JF - Clinical Medicine JO - Clin Med SP - 264 LP - 266 DO - 10.7861/clinmedicine.8-3-264 VL - 8 IS - 3 AU - Jeremy J Murphy AU - Reena Roy Chakraborty AU - Ahmet Fuat AU - Michael K Davies AU - John GF Cleland Y1 - 2008/06/01 UR - http://www.rcpjournals.org/content/8/3/264.abstract N2 - The objective of this postal survey was to assess the services currently accessed by primary care trusts (PCTs) for patients with chronic heart failure. Of the 303 PCTs in England, 225 (74%) responded to the questionnaire. Natriuretic peptides were used by 61 (26%) PCTs, whereas direct access to echocardiography was available to 163 (72%) and heart failure clinics to 95 (42%). Heart failure services were led by a cardiologist in 138 (61%) main referring hospitals, an elderly care physician in 33 (15%), and other physicians in 50 (22%). In total, 138 (62%) PCTs had access to heart failure nurses and 40 (18%) used coronary heart disease nurses; in 13 (5%) PCTs, patients with heart failure were seen by practice nurses. This survey highlights the need for further research on the cost effectiveness of service models for diagnosing and managing heart failure. The evidence base behind heart failure nurses should support their wider availability. The question of who cares for patients with heart failure should be reflected more widely in specialist training programmes in both secondary and primary care. ER -