What are the implications of the NICE Quality Standards?

The updated and expanded NICE quality standards should be used in all care settings to audit and improve services for people with chronic heart failure, according to Dr Rani Khatib, Consultant Cardiology Pharmacist, Leeds Teaching Hospitals NHS Trust.

The NICE quality standards set out what each quality statement means for different audiences such as commissioners, GPs and service providers. For example, in Quality Statement number 3, clinical pharmacists with an interest in heart failure are clearly identified as one of the groups of healthcare professionals who have a role to play. This quality standard relates to medicines and is concerned with auditing prescribed therapies. Part of this would, of course, be ensuring that patients receive appropriate, personalised treatment, explains Dr Khatib.

Taking a wider perspective, Dr Khatib would like to see the quality statements being used to assess how well services are performing in all settings – “each ICB, each surgery, each ICS, each hospital”.

“Each one of these statements [should be] assessed and audited to see how well are we doing with the diagnosis, how we are we’re doing with access to specialist services, how well are we doing in medications, how we are we doing with our reviews, and how are we doing with access to cardiac rehab. …..  we would like to see people auditing the quality of their service against these quality standards and putting plans in place in order to enhance the provisions to meet these standards”, he says.

Dr Khatib emphasises that the diagnosis of heart failure could be improved. “We need to think more heart failure we need to think about access to diagnostics such as a simple blood test – NT Pro BMP (N-terminal pro-B-type natriuretic peptide).  People who present with symptoms suggestive of heart failure should be tested because this would increase the chances of early diagnosis. “The earlier we detect heart failure the better”, he says. There is now a range of pharmacological and non-pharmacological treatment options and prompt intervention can give people better quality f life and reduce mortality, he adds.

Another area which is really important is cardiac rehabilitation.  “We’re a little bit more familiar with cardiac rehab post heart attack, post MI but I think the kind that we have for patients with heart failure has got a significant importance and benefits.  It’s something that we ought to focus on and work with commissioners and service providers in order to enhance the provision for it. It’s an area that’s not as good as we want it to be and the more we can invest in it the better, definitely”, says Dr Khatib.

About Dr Rani Khatib

Dr Rani Khatib is a Consultant Cardiology Pharmacist at Leeds Teaching Hospitals NHS Trust and Associate Professor at the Leeds Institute for Cardiometabolic Medicine (LICaM), University of Leeds. He served on the Guideline Development Group and the Quality Standards Committee for heart failure. In addition, he is Co-chair of UKCPA Cardiovascular Group, National Clinical Champion for Lipid Optimisation, AHSN, NHSE and is a member of the ESC Task Force on Cardiology Allied Professionals.

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