Before the pandemic, we needed to get a grip on heart failure. However, the pandemic has complicated the heart failure revival due to the burden of COVID-19 and the by-product of patients with long-term conditions, particularly cardiovascular. Patients were not seeing their doctors or nurses regularly throughout the pandemic, creating a backlog of people waiting to be seen, like we have never seen before. There is a backlog of people who have missed their regular appointment, check-up, investigations, and treatments and those who are either symptomatic without a diagnosis or have had a diagnosis and have not had regularity and frequency in their treatment post-diagnosis.
As a health system, we need to pick up from where we were before the pandemic. Utilise what we learned when we had to innovate at speed during the Pandemic and use this to build a more efficient and robust set of processes, using our learnings.
We know nearly all our patients are in the secondary prevention space. These are people who have one or numerous other cardiac-related conditions and now also need to manage a diagnosis of heart failure. When we ask them what they would want to change, they always come up with these four points. Firstly, they want greater recognition of heart failure symptoms in primary care. Secondly, they feel that if they had been appropriately tested, their quality of life would, in many cases, have been better. Thirdly they tell us that it is essential to have access to a multidisciplinary team managed by heart failure specialists. Fourthly both the transition and discharge from the multidisciplinary team to primary care could have been done better in many cases, especially around communication to them and also communication between the different healthcare teams.
In collaboration with a member of our Clinical Advisory Board, and NIHR Clinical Researcher at the University of Oxford and patient insights, we created a simple, memorable and relevant acronym that perfectly described one of the critical challenges patients had pre or post-diagnosis. We developed the BEAT methodology, or B.E.A.T. BEAT stands for Breathlessness, Exhaustion, Ankle swelling, Time for a simple blood test or Time to tell your GP or Nurse. Pre diagnosis it is vital as it describes the key symptoms of heart failure and action of informing your GP or nurse that maybe they should test for heart failure. Post diagnosis, the acronym also describes the key symptoms of decompensating heart failure. This is important when a patient manages their heart failure because it is essential to inform their doctor or nurse if their symptoms worsen.
The BEAT mythology is supported by patients, heart failure specialists, primary care doctors, and nurses because it is so simple and understandable. Furthermore, it works in all domains of secondary prevention because it either highlights a potential diagnosis of heart failure or works towards the better management of symptomatic heart failure.
Recently, the NHS ran a national disease awareness campaign surrounding heart attacks in England. We partnered with them on this campaign, where the BEAT methodology was adopted and recognised by the NHS.
The BEAT methodology came off the back of patient needs. Its adoption is increasing both across the medical profession and among patients. Our overall ambition is for BEAT to be recognised by all, just like FAST (Facial drooping, Arm weakness, Speech difficulties and Time) is for stroke. It puts a spotlight on the appropriate stakeholders to think could it be heart failure and, therefore should I test. Testing is the backbone to better outcomes for patients.