Case study from Innovation: early diagnosis in community settings

Simple queries on medical records alert primary care staff to people with heart failure

8 December, 2022

What is the aim?

In England, a primary care heart failure service uses simple queries on the general practice (GP) clinical system to identify people with characteristics indicative of heart failure (such taking key heart failure medications or having experienced a heart attack). The people identified have their medical records reviewed before a consultant cardiologist comes to the local GP practice for face-to-face consultations. Before the visit, people with suspected heart failure have an electrocardiogram (ECG) to assess their left ventricular ejection fraction. During the visit, the cardiologist assesses the person’s heart failure symptoms, checks the ECG, adjusts medication and refers them to the cardiology department if needed.

What has been achieved?

The service led to a 47% increase in patients being coded and therefore treated for heart failure with reduced ejection fraction (HFrEF). Coding for HFrEF was added to their GP record, which allowed the optimisation of their care. In addition, collaboration between primary and specialist heart failure services led to learning opportunities and knowledge exchange around current challenges and the latest advances in care. The service started in Manchester and is being rolled out across other services in England.


Kahn M, Grayson AD, Chaggar PS, et al. 2022. Primary care heart failure service identifies a missed cohort of heart failure patients with reduced ejection fraction. Eur Heart J 43(5): 405-12

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The Heart Failure Policy Network is an independent, multidisciplinary platform made possible with financial support from AstraZeneca and Roche Diagnostics. The content produced by the Network is not biased toward any specific treatment or therapy. All outputs are guided and endorsed by the Network’s members. All members provide their time for free. The Network is hosted by The Health Policy Partnership .