An earlier diagnosis of heart failure

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Thank you for this important editorial, but I fear it may add fuel to GP bashing. The dataset (reference 2) is dated 2010 to 2013 and I would hope (without direct evidence but from previously working as a GPwSI in cardiology) that things have changed radically in the past 9 years. Reference 7, cited for no improvement in mortality, plays down that only 7.2% of those dying had heart failure as the cause of death and that there was an improvement over the time, albeit not large, but there was no comparison in the reference to controls of the same age.

My main reason for writing is that we are de-skilling the normal GP in managing a common illness. If the guidelines empowered a GP to manage this with easy access to an echo (not forgetting initial clinical examination, ECG, and symptom treatment with diuretics) and the echo report had useful advice rather than numerical values, perhaps regular updated training to take priority over safeguarding ‘updates’ would save many more lives and improve job satisfaction.

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