After diagnosis and initial treatment most people with heart failure have follow-up care in the cardiology department at their nearest hospital, as well as with their own GP or practice nurse. The type of care varies, for instance some places have heart failure specialist nurses who care for people in the community (see 'Specialist nurses').

Follow up appointments are likely to include a discussion about general health, weight, blood pressure checks and blood tests to monitor the effects of medication. Appointments may be once a week, once a month or every few months depending on patient's needs and local arrangements. One man saw his GP every month and his cardiologist every 3 months, another had 6 appointments a year either with his cardiologist or GP (and practice nurse). Some said they kept a list of questions to ask at these appointments.

Sees his cardiologist every 3 months and his GP once a month.

He has 6 follow-up appointments a year with his GP, his consultant and a practice nurse.

Many people we talked to had been admitted and re-admitted to hospital for treatment to stabilise their heart failure, and continued to be looked after by a particular cardiology team. Cardiologists were thought to be in short supply. A 53 year old woman said she was very surprised to be given her treatment in a 'department for the elderly'.

She was surprised that she had to attend an appointment in a department for the elderly.

Most of those with severe heart failure got to know the cardiology department staff reasonably well. One woman went in to see her cardiology team every month. Some patients were concerned that they had to explain their history to a different doctor every time they went to an appointment. Even where continuity was less of an issue the departure of a particular doctor from a hospital could upset established routines and damage the patient's confidence. A man explained that when his cardiologist left he preferred to transfer to his own GP for check-ups.

She sees her GP every 8 weeks and goes to hospital every 3 months.

He misses the cardiologist he had built up a relationship with over the years.

Most people who had check-ups and follow-up appointments with their GPs were satisfied with the arrangement. Several said that GPs had listened to them, reassured them and made sure that they were regularly monitored. Others said they liked the fact that their GP held heart clinics or had a special interest in heart failure.

Sees his GP for follow-up care every 6 months.

Some people were slightly less happy with GP care. Several said that GPs did not have enough expertise in heart failure and one man who had read many books and articles about heart failure thought he knew almost as much about heart disease as his GP. A retired practice manager said her GP wouldn't touch her medication and that she felt she had to remind him to monitor her. An instance of poor communication had left one man reluctant to return to see his doctor about other health problems (see 'Communicating with medical staff').

He thinks his GP's knowledge of heart disease is very general.

Her GP is reluctant to alter her medication.

Last reviewed March 2010.