Chamber
Meeting of the Parliament 25 June 2013
25 Jun 2013 · S4 · Meeting of the Parliament
Item of business
Specialist Heart Failure Nurse Services
I am pleased that Dave Thompson has drawn our attention to the recent “Review of Specialist Heart Failure Nurse Services” and that he has secured the required cross-party support to allow it to be discussed here this evening.
The support of specialist nurses for patients who are living with heart failure and their families is invaluable, both in helping sufferers to self-manage their condition at home for much of the time, which avoids unnecessary hospital admissions, and in teaching carers and others how to deal with the complexities of what is a disabling and life-threatening affliction.
The motion neatly sums up the point at issue, which is that although, unlike in other cardiac conditions, the prevalence of heart failure is increasing, the number of whole-time equivalent specialist nursing posts has fallen since 2008 with, as we have heard, only four of Scotland’s NHS boards meeting the minimum ratio of specialist heart failure nurses to population that is laid out in SIGN guidelines, and with one NHS board having no specialist heart failure nursing service at all.
To remedy that, the Scottish heart failure nurse forum seeks a national approach to planning, adequate resourcing and further development of the specialist nursing service, in order to enable the service to meet the ever-increasing challenge of the one cardiac condition that has rising morbidity levels.
Specialist nurses deliver their services in a variety of ways across the country, depending on the resources that are available to them and their geographical location. Patients are seen in various settings including hospital wards, outpatient clinics, satellite clinics and their own homes. Most specialist heart failure nurses also give telephone support for patients, carers and GPs so that they can access advice regarding symptom management.
Unfortunately, because there are not enough specialist nurses, particularly in more remote and rural areas, there is not the capacity to deliver the education to, or share the skills and expertise with, community staff who are necessary to ensure that heart failure patients get the support that they need.
In my region, the service within NHS Grampian has been operating in a fragmented way, with part-time provision in Aberdeen city, south-central Aberdeenshire and north Aberdeenshire, and no consistent management structure from which to develop the service. Funding there is an on-going and worrying issue. Following a service break from 2007 to 2009, the service was reinstated through British Heart Foundation funding from 2009 to 2011, but now has funding guaranteed only until next year, both in the city and Aberdeenshire. Work is on-going through the managed clinical network to secure an NHS Grampian-wide service with permanent funding, but as yet the details of that are unknown and nurses in Aberdeenshire could face redeployment from this autumn. The nurses there are enthusiastic and keen to develop the service, but they are hindered by lack of administrative support, which impacts on their front-line activity with patients, and by the uncertainty about future funding for the service.
This debate is an exact parallel of last week’s debate on Parkinson’s specialist nurses and illustrates once again the patchy availability of all specialist nursing provision in Scotland. The minister in his response last week indicated the Government’s engagement on the issue and its intention to seek an improvement in nursing provision across the specialities. Given the proven savings—£1,826 per patient in the case of heart failure—through reducing hospital admissions by enabling patients to self-manage their long-term conditions in the community, and given the increasing prevalence of long-term conditions and comorbidities in an ageing population, investment in specialist services looks to be a compulsive area for preventative spending, with significant rewards both economically and for patient wellbeing.
I urge the Government to do all that it can—and very soon—to facilitate a more even spread of specialist nursing services across the specialities and across the country. I congratulate Dave Thompson on securing the debate and thank him again for highlighting such an important issue for Scotland’s NHS and its patients with heart failure and other long-term conditions.
17:59
The support of specialist nurses for patients who are living with heart failure and their families is invaluable, both in helping sufferers to self-manage their condition at home for much of the time, which avoids unnecessary hospital admissions, and in teaching carers and others how to deal with the complexities of what is a disabling and life-threatening affliction.
The motion neatly sums up the point at issue, which is that although, unlike in other cardiac conditions, the prevalence of heart failure is increasing, the number of whole-time equivalent specialist nursing posts has fallen since 2008 with, as we have heard, only four of Scotland’s NHS boards meeting the minimum ratio of specialist heart failure nurses to population that is laid out in SIGN guidelines, and with one NHS board having no specialist heart failure nursing service at all.
To remedy that, the Scottish heart failure nurse forum seeks a national approach to planning, adequate resourcing and further development of the specialist nursing service, in order to enable the service to meet the ever-increasing challenge of the one cardiac condition that has rising morbidity levels.
Specialist nurses deliver their services in a variety of ways across the country, depending on the resources that are available to them and their geographical location. Patients are seen in various settings including hospital wards, outpatient clinics, satellite clinics and their own homes. Most specialist heart failure nurses also give telephone support for patients, carers and GPs so that they can access advice regarding symptom management.
Unfortunately, because there are not enough specialist nurses, particularly in more remote and rural areas, there is not the capacity to deliver the education to, or share the skills and expertise with, community staff who are necessary to ensure that heart failure patients get the support that they need.
In my region, the service within NHS Grampian has been operating in a fragmented way, with part-time provision in Aberdeen city, south-central Aberdeenshire and north Aberdeenshire, and no consistent management structure from which to develop the service. Funding there is an on-going and worrying issue. Following a service break from 2007 to 2009, the service was reinstated through British Heart Foundation funding from 2009 to 2011, but now has funding guaranteed only until next year, both in the city and Aberdeenshire. Work is on-going through the managed clinical network to secure an NHS Grampian-wide service with permanent funding, but as yet the details of that are unknown and nurses in Aberdeenshire could face redeployment from this autumn. The nurses there are enthusiastic and keen to develop the service, but they are hindered by lack of administrative support, which impacts on their front-line activity with patients, and by the uncertainty about future funding for the service.
This debate is an exact parallel of last week’s debate on Parkinson’s specialist nurses and illustrates once again the patchy availability of all specialist nursing provision in Scotland. The minister in his response last week indicated the Government’s engagement on the issue and its intention to seek an improvement in nursing provision across the specialities. Given the proven savings—£1,826 per patient in the case of heart failure—through reducing hospital admissions by enabling patients to self-manage their long-term conditions in the community, and given the increasing prevalence of long-term conditions and comorbidities in an ageing population, investment in specialist services looks to be a compulsive area for preventative spending, with significant rewards both economically and for patient wellbeing.
I urge the Government to do all that it can—and very soon—to facilitate a more even spread of specialist nursing services across the specialities and across the country. I congratulate Dave Thompson on securing the debate and thank him again for highlighting such an important issue for Scotland’s NHS and its patients with heart failure and other long-term conditions.
17:59
In the same item of business
The Deputy Presiding Officer (Elaine Smith)
Lab
The final item of business is a members’ business debate on motion S4M-06245, in the name of Dave Thompson, on review of specialist heart failure nurse servi...
Dave Thompson (Skye, Lochaber and Badenoch) (SNP)
SNP
The motion was stimulated by a discussion at the cross-party group on heart disease and stroke, of which I am a vice-convener, in March. At that meeting, we ...
Jackie Baillie (Dumbarton) (Lab)
Lab
I pay tribute to Dave Thompson for securing this debate and I commend the British Heart Foundation, the Scottish heart failure nurse forum and Chest Heart & ...
Dave Thompson
SNP
It has just occurred to me that it was remiss of me not to mention that NHS Highland in my area is one of the four health boards that are meeting the target.
The Deputy Presiding Officer (John Scott)
Con
Better late than never.
Jackie Baillie
Lab
That is truly wonderful. We are nothing if not parochial.We have established that heart failure is rising, we agree that we need to try to ensure that servic...
Nanette Milne (North East Scotland) (Con)
Con
I am pleased that Dave Thompson has drawn our attention to the recent “Review of Specialist Heart Failure Nurse Services” and that he has secured the require...
Dennis Robertson (Aberdeenshire West) (SNP)
SNP
I, too, congratulate Dave Thompson on securing a debate on this important subject and bringing it to the chamber. I also thank the organisations, particularl...
Liam McArthur (Orkney Islands) (LD)
LD
I, too, congratulate Dave Thompson on his motion and on securing the debate. I also add my thanks to Chest Heart & Stroke Scotland, to the British Heart Foun...
The Minister for Public Health (Michael Matheson)
SNP
I congratulate Dave Thompson on securing time for this important debate on what remains a clinical priority for NHS Scotland.I am sure that all members recog...
Dennis Robertson
SNP
Will the minister take an intervention?
Liam McArthur
LD
Will the minister take an intervention?
Michael Matheson
SNP
I will give way to Mr McArthur.
Liam McArthur
LD
I am grateful to the minister for giving way. I appreciate what he said in relation to ratios but, as he will have heard, there is no ratio at all in the cas...
Michael Matheson
SNP
I am going to come to Orkney in a minute, when I hope that I can address that point.I am more than happy to give way to Mr Robertson, too.
Dennis Robertson
SNP
I thank the minister for giving way. With regard to the ratios, does the minister share my concern that in Aberdeen there is only one specialist nurse with a...
Michael Matheson
SNP
I will turn to those points on Orkney and Grampian after making a little progress on the wider issue.It is important to recognise that some progress has been...