Project: Heart failure policy and practice in Europe

Heart failure policy and practice in Europe
Heart failure policy and practice in Europe aims to support advocates with clear outline of policy issues and best practice in heart failure across 11 European countries.

What is Heart failure policy and practice in Europe?

The growing prevalence of heart failure threatens the sustainability of our healthcare systems – concerted action is required, yet few policymakers recognise the magnitude of the heart failure challenge, both in terms of its economic and societal impact.

Heart failure policy and practice in Europe aims to better equip and further empower national advocates across Europe with a clear picture of central leadership and overall performance in terms of major pillars of health services, treatment and care. It provides a comprehensive analysis of national policy issues in heart failure, key gaps in care and examples of best practice investigated in 11 European countries.

This work, which is the natural successor to The handbook of multidisciplinary and integrated heart failure care, was developed based on the literature and input from more than 50 heart failure experts across Europe. It includes a pan-European report and 11 standalone country profiles, each with five urgent actions needed to improve the lives of people living with heart failure.

Download the European report

Heart failure policy and practice in Europe

Download the country profiles

Heart failure policy and practice in Europe: Belgium Heart failure policy and practice in Europe: Denmark Heart failure policy and practice in Europe: England Heart failure policy and practice in Europe: France Heart failure policy and practice in Europe: Germany Heart failure policy and practice in Europe: Greece Heart failure policy and practice in Europe: Ireland Heart failure policy and practice in Europe: Italy Heart failure policy and practice in Europe: Poland Heart failure policy and practice in Europe: Portugal Heart failure policy and practice in Europe: Spain

Why is this work important?

Despite the urgency of heart failure, advocates across Europe face persistent barriers in mounting political engagement efforts. This project seeks to challenge these barriers in greater national specificity than ever before. It provides an evidence-based, consensus-driven tool to help advocates demand at least an answer from national leaders, and ideally an offer of partnership.

The work is based on a list of elements for consideration in each country: the HF policy and practice indicators. These indicators fall into two domains: policy indicators are those that focus on the status and comprehensiveness of HF policies and guidance, while practice indicators aim to capture the reality of clinical practice.

Policy indicators:

  • Formal plans on HF
  • Investment in integrated HF models and facilitative tools
  • Development of the HF healthcare workforce
  • Guidance and local care pathways for delivery of quality care
  • Registries, audits and high-level assessment initiatives

Practice indicators:

  • Diagnosis
  • Hospital care and discharge
  • Key components of quality care in community settings
  • Tools and methods to support multidisciplinary and integrated ongoing HF care

These indicators were used to investigate the reality of HF policy and care delivery in Belgium, Denmark, England, France, Germany, Greece, Ireland, Italy, Poland, Portugal and Spain.

Case Studies

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The following case studies are based on research that was conducted in 2020.
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Endorsements

The following organisations endorse this project:

Project Advisory Group

Josep Comín-Colet
Cardiologist; Director of Cardiology, University Hospital Bellvitge; Director, South Metropolitan Barcelona Integrated Heart Failure Programme; Director, Cardiovascular Disease Research Group, IDIBELL
Andrzej Gackowski
Cardiologist; Head of the Non-invasive Cardiovascular Laboratory, John Paul II Hospital Krakow; Past-President, HF Working Group of the Polish Society of Cardiology
José Ramón González Juanatey
Cardiologist; Professor of Cardiology and Director of the Cardiology and Intensive Care Department, University Hospital Santiago de Compostela; Past-President, Spanish Society of Cardiology
Anne-Catherine Pouleur
Cardiologist; Head of Cardiology, Clinique universitaires Saint-Luc; President, Belgian Working Group on Heart Failure and Cardiac Function
José Silva-Cardoso
Cardiologist; Associate Professor, University of Porto; Coordinator, Heart Failure Working Group of the Portuguese Society of Cardiology
Salvatore Di Somma
Internist and Cardiologist; Professor of Medicine, University of Rome La Sapienza; President of Scientific Committee, Italian Association of Patients with Heart Failure (AISC)
Joana Pimenta
Internist; Invited Assistant Professor, University of Porto; Deputy Coordinator, Heart Failure Working Group of the Portuguese Society of Internal Medicine
Ekaterini Lambrinou
Cardiology and Gerontology Specialist Nurse; Associate Professor, Cyprus University of Technology; Past-Chair, ESC Association of Cardiovascular Nursing and Allied Professions
Sandra Mulrennan
Heart Failure Specialist Nurse; St Bartholomew’s Hospital Heart Failure Service, Barts Health NHS Trust
Elizabeth Killeen
Heart Failure Specialist Nurse, Community Healthcare West, Galway
Bert Vaes
General Practitioner; Assistant Professor, Department of Public Health and Primary Care, KU Leuven
Steven Macari
Founder and President, Association Vie Et Cœur (AVEC)
Neil Johnson
Chief Executive, Croí, West of Ireland Cardiac Foundation; President, Global Heart Hub
Pascal Garel
Chief Executive, HOPE (European Hospital and Healthcare Federation) 

In addition to the Project Advisory Group, national experts in each country shared their knowledge in interviews and supported the development of the respective country profiles.

Belgium

  • Damien Gruson, Specialist in Laboratory Medicine; Head of Department of Clinical Biochemistry, Cliniques universitaires Saint-Luc
  • Anne-Catherine Pouleur, Cardiologist; President of Belgian Working Group on Heart Failure and Cardiac Function; Chef de Clinique, Clinique universitaires Saint-Luc; member of our Project Advisory Group
  • Miek Smeets, General Practitioner; Academic Centre for General Practice, KU Leuven
  • Jan Vercammen, Heart Failure Nurse; Co-Chair, Belgian Heart Failure Nurses

Denmark

  • Hans Eguia, General Practitioner; member of working group on telemedicine for home monitoring of heart failure, Danish College of General Practitioners
  • Søren Lund Kristensen, Resident in Cardiology, Rigshospitalet
  • Brian Bridal Løgstrup, Cardiologist, Aarhus University Hospital; President, Heart Failure Working Group of the Danish Society of Cardiology
  • Inge Schjødt, Clinical Nurse Specialist, Aarhus University Hospital; Co-president, Danish Heart Failure Registry

England

  • Majid Akram, GP; Locality Clinical Lead, Lincolnshire Clinical Commissioning Group
  • Andrew L Clark, Consultant Cardiologist and Chair of Clinical Cardiology, Hull University Teaching Hospitals NHS Trust
  • Louise Clayton, Advanced Nurse Practitioner; Co-Chair, Alliance for Heart Failure; Observer to the Board, British Society for Heart Failure
  • Martin Cowie, Cardiologist; Professor of Cardiology, Imperial College London; Chair of Digital Health Committee, European Society of Cardiology
  • Nick Hartshorne-Evans, Founder and Chief Executive, Pumping Marvellous Foundation
  • Naresh Kanumilli, GP with Special Interest in Cardiology; Community Diabetes Consultant, Manchester University Foundation Trust; Clinical Network Lead for Diabetes, Greater Manchester; Diabetes Research Lead, Greater Manchester Research Network

France

  • Nicolas Girerd, Cardiologist, Centre Hospitalier Universitaire (CHU) de Nancy; Deputy Director, Nancy Clinical Investigation Centre
  • Benoît Lequeux, Cardiologist, Centre Hospitalier Universitaire (CHU) de Poitiers
  • Steven Macari, Founder and President, Association Vie Et Cœur (AVEC); member of our Project Advisory Group
  • Antoine Malone, Director of Foresight, French Hospitals Federation; Liaison Officer and National Coordinator, European Hospital and Healthcare Federation (HOPE)

Germany

  • Klaus Edel, Cardiologist; Director, Clinic for Rehabilitation and Prevention, Centre for Cardiovascular Diseases, Rotenburg an der Fulda
  • Winfried Klausnitzer, Founder and Board Member, Herzschwäche Franken e.V.
  • Gabriele Meyer, Heart Failure Nurse, South Nuremberg Hospital; Board Member, Herzschwäche Franken e.V.
  • Stefan Störk, Cardiologist; Professor and Head of Department of Clinical Research and Epidemiology, Comprehensive Heart Failure Centre, University Würzburg and University Hospital Würzburg

Greece

  • Kostas Athanasakis, Health Economist, University of West Attica
  • Spyros Linardos, Nurse; President, Working Group of Cardiac Nursing, Hellenic Society of Cardiology
  • Christos Lionis, General Practitioner; Professor of General Practice and Primary Health Care, Head of Clinic of Social and Family Medicine Faculty of Medicine, University of Crete
  • Dimitrios Richter, Cardiologist; Past-Chairperson, European Society of Cardiology Council for Cardiology Practice
  • Panos Stafylas, Cardiologist; Health Technology Assessment Consultant, Scientific Director, Healthink

Ireland

  • Norma Caples, Lead Nurse for National Heart Programme; Clinical Nurse Specialist, University Hospital Waterford; President, Irish Association of Heart Failure Nurses; Vice-President, Irish Nurses Cardiovascular Association
  • Joseph Gallagher, General Practitioner; Clinical Lead in Cardiovascular Disease, Irish College of General Practitioners
  • Chris Macey, Head of Advocacy, Irish Heart Foundation
  • Ken McDonald, Clinical Lead for National Heart Programme; Founder and Medical Director, Heart Failure Unit, St Vincent’s University Hospital; Medical Director, HeartBeat Trust
  • Ambrose McLoughlin, Chairman, HeartBeat Trust; former Secretary General, Department of Health

Italy

  • Salvatore Di Somma, Internist and Cardiologist; Professor of Medicine, University of Rome La Sapienza; President of Scientific Committee, Italian Association of Patients with Heart Failure
  • Aldo Pietro Maggioni, Director, National Association of Hospital Cardiologists Research Centre
  • Ercole Vellone, Associate Professor in Nursing Science, Department of Biomedicine and Prevention, University of Rome Tor Vergata

Poland

  • Piotr Hetman, Radiographer; Paramedic; Chair, Nursing and Medical Technology Section of the Polish Cardiac Society
  • Beata Jankowska-Polańska, Professor of Nursing; Specialist in Cardiology and Geriatric Nursing; Health Educator, Medical University in Wrocław, University Teaching Hospital in Wrocław
  • Dorota Krówczyńska, former Chair, Nursing and Medical Technology Section of the Polish Cardiac Society
  • Przemysław Leszek, Cardiologist; Chair, Heart Failure Association of the Polish Cardiac Society
  • Ewa Straburzyńska-Migaj, Cardiologist; former Chair, Heart Failure Association of the Polish Cardiac Society
  • Izabella Uchmanowicz, Nurse; President-Elect, Association of Cardiovascular Nursing and Allied Professions of the European Society of Cardiology; Past-President, Nursing and Medical Technology Section of the Polish Cardiac Society

Portugal

  • Dulce Brito, Senior Cardiologist, Head of the Cardiomyopathies Unit and Coordinator of the Heart Failure & Telemonitoring Programme, Heart and Vessels Department, Centro Hospitalar Universitário Lisboa Norte
  • Luís Campos, Internist and Director of the Medical Service, São Francisco Xavier Hospital; Chairman of the Quality and Professional Issues Subcommittee of the European Federation of Internal Medicine; former President, Portuguese Society of Internal Medicine
  • Cândida Fonseca, Senior Cardiologist and Internist, Head of Heart Failure Clinic of São Francisco Xavier Hospital; former Coordinator of the Heart Failure Working Group, Portuguese Society of Cardiology
  • Luís Filipe Pereira, President, Association for Support to Patients with Heart Failure (AADIC); former Minister of Health
  • Susana Quintão, Nurse Coordinator of Outpatient HF Clinic, São Francisco Xavier Hospital

Spain

  • Lluïsa García-Garrido, Heart Failure Nurse, Dr Josep Trueta University Hospital; Representative, Heart Failure Working Group of the Spanish Association of Nurses in Cardiology
  • José Manuel García-Pinilla, Cardiologist; Past-President, The Heart Failure Association of the Spanish Society of Cardiology
  • Álvaro González Franco, Internist; Coordinator, Heart Failure and Atrial Fibrillation Working Group of the Spanish Society of Internal Medicine
  • Juan Carlos Obaya, Family Medicine Practitioner; Coordinator, Cardiovascular Disease Working Group of the Spanish Society of Family and Community Medicine
  • Maite San Saturnino, President, Cardioalianza

 

 

Funders

The development of Heart failure policy and practice in Europe was made possible with financial support from Novartis Pharma and AstraZeneca.

The Heart Failure Policy Network is made possible with financial support from Novartis Pharma, AstraZeneca and Vifor Pharma. The content produced by the Network is non-promotional and not biased to any specific treatment or therapy. All outputs are guided and endorsed by the Network’s members.