UK Heart Failure Patients Miss Life-saving Treatments, Expert Warns

⁢ ​ Updated June 04, 2025

Thousands ⁢of people in ‌the United kingdom with advanced heart failure are not‍ being referred for possibly⁤ life-saving treatments, according to Owais Dar, consultant cardiologist at Harefield Hospital,⁤ Guy’s ⁤and St Thomas’ NHS Foundation Trust, London.Speaking at the British Cardiovascular⁢ Society Annual Conference 2025, Dar highlighted a ⁢”systemic failure” in providing heart transplants and left ventricular⁢ assist devices (LVADs) to eligible‍ patients, leading to critical delays in care for⁤ advanced heart ⁣failure.

data from a National Advanced Heart ‌Failure Audit suggests that approximately 10,000 adults under 65, who could benefit from ‍a heart transplant or LVAD therapy, have ‌not been referred to specialist services. Furthermore, an‌ estimated 130,000 adults with​ advanced heart failure require⁤ palliative care.

Dar, also an honorary senior lecturer at King’s College London,⁤ expressed concern ⁣over the disparity in treatment access. He noted significant variations in referral patterns across the ‍UK and Ireland, where transplant or ⁤LVAD therapy is frequently ⁤enough not considered⁤ as a viable option.

Geraint Jenkins, ⁢consultant cardiologist‍ at ​Morriston Hospital in Swansea, Wales, acknowledged⁣ the‌ improvements in medical therapy, noting that many patients⁤ with reduced ‌heart function recover within a year and do not require transplant services. However, he cautioned⁤ against overly ‌broad referral criteria that could overwhelm specialist centers. Jenkins emphasized the need to identify the right patients at ⁢the right ⁣time to ensure efficient resource allocation ⁤for heart failure treatment.

“If this was a cancer, we would be furious about this,” said ‍Dar.⁤ “We’ve got young ‌people here who are not⁢ accessing [these therapies].”

Dar ⁢pointed out that while the availability of donor hearts may be ‌limited, modern LVADs offer a viable alternative. These mechanical pumps can ⁤support ‌circulation in patients with severely ⁣weakened hearts, either ⁣as a ⁣long-term solution or as a bridge to transplant. He added that many patients already have access ‌to advanced treatments like ⁣ICDs and cardiac resynchronization therapies (CRTs), but LVADs can substantially improve their quality of life, allowing them ‌to return to work, exercise, and lead more active lives.

Advanced heart ​failure carries a high mortality risk, with one-year⁣ mortality ⁤rates ranging from 20% ​to 40% depending on the criteria used. Extrapolating US data ​to the UK population suggests that approximately 140,000 people have advanced heart failure, with 50,000 under 65 and 10,000 eligible for transplantation ⁢or LVAD ​therapy.

The audit revealed significant regional disparities in referral rates,creating a “postcode lottery” ‌for patients. Areas in Wales and the Northeast ⁤of England showed especially ⁣low⁤ referral rates, even in regions near specialist transplant centers. Factors such as high body mass index,​ liver or kidney failure,⁣ diabetes-related organ damage, and⁤ smoking were key exclusion criteria.

To address these inequalities,Dar and other ⁢transplant physicians have formed a working group to create a heatmap of referrals and assess equity​ of care for‍ heart failure patients.

What’s⁤ next

Dar plans to‍ collaborate with ​NHS England to address the identified inequalities and ⁣raise awareness of the issue. He suggested‌ creating a national ⁢pathway to ensure timely ⁤specialist evaluation for individuals with ⁢suspected advanced heart failure. Jenkins proposed that specialists could hold monthly clinics within existing heart failure centers to improve access for ​patients in rural areas. Both experts emphasized the need for increased awareness and early conversations between physicians and transplant centers ⁤to improve⁢ outcomes for heart failure patients.