Thousands of heart patients die or become seriously ill as a result of waiting years to see NHS specialists

Heart failure patients are dying or becoming seriously ill due to serious delays in NHS treatment, experts have warned.

It is feared that hundreds or possibly thousands of deaths and hospitalizations occur each year among patients who have to wait a year or more to see a specialist. Many of these deaths could be prevented if tests and medications were given earlier.

A new study finds that most patients who visit their GP with symptoms of heart failure, such as shortness of breath, extreme fatigue and swollen ankles, have to wait at least a year before receiving a diagnosis from a cardiologist.

Although there is no cure for heart failure, cardiologists can prescribe a variety of essential medications that prolong survival and significantly improve quality of life.

The most effective of these – so-called SGLT2 inhibitors – can reduce the risk of being admitted to hospital with heart failure by more than 30 percent.

However, according to treatment guidelines, NHS GPs are not allowed to prescribe these drugs for heart failure, although they are allowed to prescribe them for other conditions, such as diabetes and kidney disease.

Critics claim that as a result, patients end up seriously ill in hospital or die while waiting to see a specialist.

The researchers behind the findings, based on a study of more than 8,000 patients, called the delays “a scandal” and called for immediate changes to the way suspected cases of heart failure are treated.

“We regularly see patients dying while on the waiting list to see a cardiologist,” said Dr Lisa Anderson, one of the researchers and a heart failure specialist at St George’s University Hospitals NHS Foundation Trust in London.

‘Many also end up seriously ill in hospital. Of these, 40 percent die from heart failure within a year. These patients wait far too long before seeing a specialist.’

More than a million people in the UK have heart failure, with 200,000 new cases each year, according to the British Heart Foundation. It develops when the heart becomes too weak to pump oxygen-rich blood efficiently around the body.

It is common in heart attack survivors, but can also be caused by high blood pressure, defective heart valves, diabetes and even sleep apnea.

The Health Foundation charity predicts that the population will double to two million by 2040 due to an aging population and rising obesity rates.

People who go to their doctor with worrying symptoms should have a blood test to measure levels of a protein called brain natriuretic peptide (BNP), which is produced by the heart and blood vessels. The levels in people with heart failure are usually much higher than normal.

If their levels are extremely high, GPs should do a rapid referral, so that patients are seen by a specialist within two weeks. A cardiologist can then prescribe medications, including SGLT2 inhibitors, to improve the heart’s pumping efficiency. But Dr Anderson says many GPs don’t do the tests or, if they do and the BNP level is elevated, they don’t do the rapid referral.

The new study, presented last week at a heart failure conference in Lisbon, looked at data from 8,000 patients in Sweden and found that more than two-thirds of people with elevated BNP levels and symptoms of heart failure still did not have a clear diagnosis or the right drug treatment a year after they first went to the doctor.

Although the data is Swedish, British researchers indicate that the study also reflects what is happening here.

Dr. Antoni Bayes-Genis, another researcher and a leading heart specialist in Spain, told the conference: ‘It’s a scandal. Patients go to their GP, get tested for BNP and nothing happens. There are a large number of deaths that probably could have been prevented.”

According to the British Heart Foundation, more than a million people in the UK suffer from heart failure, with 200,000 new cases every year.

The findings mirror those of a recent study by doctors in an operating theatre in east London, which followed 77 patients with symptoms of heart failure.

Although 72 percent had concerning BNP levels, the average wait time to see a cardiologist was six months or more. Researchers warned: ‘This puts patients at risk. We need a national screening program in primary care.’

A Mail on Sunday reader in his 70s wrote earlier this month that he was shocked to discover his BNP levels had increased during a routine health check.

“Now I have an appointment to speak to a cardiologist on the phone… mid-October,” he said. “Am I concerned that my interests are not being properly represented, or is this kind of ‘treatment’ normal in a post-Covid world?”

It is estimated that around 100,000 patients a year in the UK eventually require emergency hospital treatment for heart failure, at least partly due to cardiological delays.

Dr Anderson and her colleagues at St George’s are now seeking funding for a study to see whether starting patients on SGLT2 inhibitors sooner will improve their chances of survival.

• Have you had to wait for a heart failure assessment? Write to health@mailonsunday.co.uk.