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Economic assessment of a nurse-led heart failure liaison service in NHS Tayside

Jill Nicholls, Heart Failure Specialist Nurse, NHS Tayside, Scotland

Jill's case study was completed in June 2013 and reflects 2013 prices

A heart failure specialist nursing service in NHS Tayside delivers high-quality, patient-centred care at home that improves patient outcomes, cuts hospital admissions and avoids costs of over £250,000 per year.

Jill Nicholls was one of three Clinical Nurse Specialist's providing a nurse-led service for patients diagnosed with heart failure. The service had been running for 10 years and it had never been formally reviewed over that time. However the workload was ever increasing.

By undertaking the programme Jill was able to demonstrate the value of her service. Jill knew there were clinical benefits but by applying the principles of economic assessment laid down by HM Treasury, Jill was able to show economic benefits for NHS Tayside and the wider economy. In the process Jill uncovered that approximately 40% of patients who could benefit from her service were not being referred. Armed with this evidence Jill and her Director of Nursing Services explored how the rehabilitation and palliative care needs of all patients diagnosed with heart failure in NHS Tayside can be addressed more effectively and efficiently.

Jill Nicholls is a Heart Failure Specialist Nurse with NHS Tayside's HFNLS and is seconded part-time to serve as one of the Scottish Government's Heart Failure Hub Co-ordinators. She chairs the Heart Failure Nurse Forum in Scotland and also sits on the Scottish Intercollegiate Guidelines Network (SIGN) heart failure review group.

You can email Jill at

Case study
One page summary
RCN Scotland policy briefing