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The NHS Highland Heart Failure Service, which starts in April, should reduce the number of times patients discharged from hospital have to return for further treatment.

Five nurses based across the Highlands, who are specially trained in heart failure management, will work together with the community staff to show them how they can stay healthy. There will be one part time nurse covering Caithness and Sutherland, two nurses covering Ross-shire and Lochaber and 1 part time nurse and a full time nurse covering Inverness, Badenoch and Strathspey and Nairnshire.

Chronic Heart Failure is the most expensive cause of hospital admissions in people over the age of 65 in the UK. In 2004 there were 6,083 bed days for heart failure in the Highlands, 4,004 of which were in the acute hospitals. Current patients range in age from 18 to 91, although most are between 60 and 70.

Mandi Smith, Lead Heart Failure Nurse, said: �Many patients have a limited knowledge and understanding of their condition and its treatment.

�Studies report that patients often forget or alter their complicated medication regime. Many of their drugs are diuretics (water tablets) which means they have to go to the toilet more often. This makes them inconvenient and leads to the patients not taking them.

�Research has shown that use of nurse-led intervention in targeting high-risk patients and providing basic education about their symptoms and how to manage them reduces the number of patients who have to return to hospital.�

She added: �We will advise patients who have been treated in hospital on how to look after themselves when they return to their homes. This will hopefully mean they stay healthy and have fewer hospital visits, thus saving NHS Highland resources in the process and caring for the patients within their homes.

The key components of the service are:

• Regular contact with patients to detect deterioration of condition.
• Continued adjustment and maximum possible use of drug therapy.
• Teaching patients to monitor their weight and to detect early signs of salt and water retention.
• Teaching patients to adjust their medication according to symptoms (or making this adjustment for them)
• Monitoring blood chemistry and giving dietary advice.
• Encouraging drug and diet compliance.
• Acting as an intermediary between the patient and other health care professionals in both a GP and hospital setting.
• Providing education and training for other health care professionals (eg District Nurses and Practice Nurses) involving the care of patients with heart failure.

The British Heart Foundation and NHS Highland have agreed to fund the project for the next five years.

It will work alongside the direct access ECHO service, which will help GPs to diagnose heart failure.

GPs, community nurses, hospital staff and practice nurses within NHS Highland�s South East Highland area are invited to a meeting to learn all about the Heart Failure Service at the Culloden House Hotel at 7:30pm on Wednesday January 17th.

Similar sessions will be organised when the other nurses are appointed.