Heart failure outreach: a targeted and evidence-based approach to engage UK parliamentarians

The challenge

National healthcare plans in England, Scotland and Wales recognise heart failure as a priority,^1-3 but awareness of the syndrome and its impact remains low among UK policymakers. In a 2020 survey, only 12% recognised heart failure as the biggest cause of preventable hospitalisations.⁴ This limited awareness, paired with competing political priorities (such as recovery from the COVID-19 pandemic) can make it difficult for advocates to engage policymakers and ensure continued commitments to improve heart failure care.⁵

The response

The British Society for Heart Failure (BSH), a multidisciplinary professional society, has a director of external affairs.⁶ Their responsibilities include regular, tailored outreach to engage Members of Parliament (MPs) on heart failure. By leading outreach to parliamentarians and educating its clinical membership, the BSH aims to make heart failure a national priority and improve patient care and outcomes.⁶

The BSH focuses its efforts on geographical areas with the most pronounced unmet needs.^{5 7} For example, the society will identify which parliamentary constituencies underperform compared with the national average on key indicators, such as heart failure outcomes, health inequalities and deprivation. Parliamentarians’ voting records can also help the BSH to identify MPs with an existing interest in heart failure, cardiovascular disease and/or health inequalities.⁷ This information is often publicly available from national registries, governmental bodies, professional societies and non-governmental organisations.

Based on this information, the BSH will engage individual MPs using a personalised approach (often a formal letter) that:⁷

• highlights local data: a summary of heart failure incidence, prevalence, hospital admissions, healthcare costs and patient outcomes helps illustrate the relevance and impact of the syndrome in the MP’s constituency
• aligns with wider political objectives: using data, the BSH presents action on heart failure as part of the solution to wider societal issues in the MP’s constituency, such as health inequalities and racial disparities. It considers current affairs and commitments outlined in manifestos, policies and healthcare plans to identify topics that are most likely to resonate with MPs.

BSH representatives have reported that personalised letters can open the door for future in-person or virtual discussions with MPs and their special advisers.^{5 7} In these meetings, the BSH provides additional evidence to make the case for action and outlines actionable recommendations to address heart failure in the MP’s constituency. For example, they may suggest that MPs table questions in Parliament, contact the clinical leads of national and regional healthcare structures, or set up multidisciplinary working groups to achieve a particular policy goal.

What has been achieved?

In October 2020, the BSH contacted a specific target group of MPs to request a meeting to discuss the links between deprivation, inclusion and heart failure in their constituencies.⁷ The letter highlighted that the local rate of heart failure hospitalisations was higher than the national average, and pinpointed the unmet needs of the local population, including the disproportionate impact of the COVID-19 pandemic on minority ethnic communities. The letter then invited the MPs to ensure that the interests of these communities were better represented in the health system.⁷

Following this targeted approach, the BSH has established strong relationships with a number of parliamentarians, including Virendra Sharma, MP for Ealing and Southall in London. Two hours after receiving the letter from the BSH, Mr Sharma responded to the society and tabled four parliamentary questions for the Under Secretary of State for Health and Social Care.^8-11 He highlighted the impact of the COVID-19 pandemic on heart failure services and called for improved representation and access to care for people living with heart failure, particularly in minority ethnic communities. The BSH continues to work with Mr Sharma to improve the lives of people with heart failure in his constituency.⁵

In addition to personalised outreach, the BSH organises virtual parliamentary drop-in sessions to raise awareness of heart failure among MPs.⁷ In March 2021, the society organised a session in collaboration with the British Heart Foundation. Both organisations were joined by people living with heart failure and heart failure specialists, who invited their local MPs to the event.⁵ The session prompted MPs to act: more than half of those attending reached out to the clinical leaders of their regional healthcare structures, calling for a more robust care pathway for heart failure.

The BSH has engaged a core group of MPs to continually advocate for heart failure at both the regional and the national level.⁵ The society’s efforts have brought the syndrome to the attention of health ministers as well as decision-makers in NHS England and NHS Improvement.⁷

Next steps

As established with its ‘Freedom from Failure – the F word’ campaign, a strategic priority for the BSH is to support earlier detection and diagnosis of heart failure, particularly in primary care and community settings.⁵ With support from MPs, the society hopes to engage regional healthcare structures to increase awareness of heart failure symptoms and the use of essential diagnostic tests, such as natriuretic peptide testing, in primary care.