After RN training in Dublin, Ireland in the late 80’s and due job prospects, I came to the UK in 1989 for 6 months! Starting in CCU then branching out to Cardiothoracic ITU in Australia for a year. I established the heart failure service in Ealing Hospital in 2003 alongside Professor Stuart Rosen. From the offset our service managed heart failure, not just systolic dysfunction but right sided, preserved and valve disease. This evolved in to a Community Heart Failure service under Imperial College Healthcare. I lead a busy service with 7 CNS, 2 part-time, and a caseload of almost 1000 patients. We see patients in clinic and at home, where we confirm diagnosis of heart failure, initiate, titrate and optimise disease modifying medications in line with NICE, ESC and SIGN Guidelines. We refer for specialist intervention and ongoing management under other specialities. We are part of a true Multi Disciplinary Team with regular meetings with other specialities including, Care of Elderly, Palliative Care and IAPT as well as new relationships with Diabetes and Renal physicians.
We work very closely with our nearest DGH and have established a heart failure lounge where our patients, who we are struggling to offload with oral diuretics, can go in as a day case for IV Furosemide and IV Iron. For this piece of work last year we were highly commended at the HSJ Awards and have had a further nomination this year.