Inadequate follow-up and long-term care in primary care is one of the key reasons why patients with heart failure often end up being admitted to hospital. GPs are usually the first point of contact for patients with heart failure. However, they often do not have the time or resources to monitor their patients, and nurses with specific training in heart failure are usually not available to fulfil this role.
Innovative tools that encourage self-care – for example patient self-monitoring tools – may also help keep heart failure patients out of hospital. However, in most countries these tools are often stuck in ‘pilot’ mode because of logistic or institutional barriers and are not implemented on a broad scale.
If we are to improve outcomes for people living with heart failure, we urgently need careful workforce planning and better use of tools that encourage self-management in primary care. Each healthcare setting needs to explore the feasibility of different approaches to suit their particular context.