Waikato's Integrated Heart Failure Service started in December at Te
Kuiti Hospital with the second community-based clinic planned in Tokoroa
next week.

With nearly twice the heart failure admission rates of Hamilton, the
Waitomo and South Waikato districts were chosen as one-year pilot sites
for the Waikato Integrated Heart Failure Programme, a joint venture
between Waikato Clinical School, Waikato District Health Board and
Waikato Primary Health.

"Heart failure is a debilitating and costly disease," said Waikato DHB
medical officer of health Anita Bell.

"The ageing population and enhanced survival of coronary heart disease
patients now means heart failure is a significant public health
concern."

There is an average of 643 heart failure admissions to Health Waikato
services every year.

"An abundance of evidence now exists to support integrated care
programmes in the management of heart failure patients to help optimise
treatment," said Waikato DHB's director of Cardiology Gerry Devlin.

"This leads to reduced hospitalisations and improved wellbeing. However,
the difficulty is establishing the type of programme that fits local
needs, as not one size fits all."

 "This programme aims to improve the range of services available in the
community setting and focus on supporting general practice teams through
improved access to cardiologists and diagnostic services with visiting
mobile clinics," said Dr Bell.

Specialty heart failure nurses Debbie Brooks and Eileen Gibbons are also
based in the Te Kuiti and Tokoroa communities.

Te Kuiti Medical Centre GP Keith Buswell said the new service is a
valuable addition to the services available locally for people with
heart failure.

"A closer working relationship with Waikato Hospital's Cardiology
Service and the ability to offer echocardiograms at outpatient clinics
coupled with a nurse-led community service means our patients' heart
conditions can be managed more effectively," said Dr Buswell.

Dr Bell said the expectation was that coordinating the care of heart
failure patients between primary and secondary care would improve the
knowledge, diagnosis and management of heart failure.

"Hopefully, working towards better coordinating heart failure services
may also lead to a reduction in referrals and admissions or readmissions
to secondary care."

Beyond the initial 12-month pilot period, the programme's future will
depend on whether it identifies 'at risk' patients in early stages of
heart failure and optimises their diagnosis and treatment at a community
level as is hoped.

As part of the programme, the two clinical nurse specialists and a
cardiologist with expertise in heart failure have been appointed to work
in the community, as well as at Waikato Hospital.

A portable echocardiography machine has also been purchased to enable
heart scans to be performed in sites such as Te Kuiti and Tokoroa.