• Project led by University Hospital of North Staffordshire NHS Trust.
  • Focused on hospital services for heart failure patients.
  • Aimed to reduce demand for inpatient beds for heart failure patients, while also maintaining and improving quality of care and clinical effectiveness.
  • Set up a heart failure day clinic to provide specialist clinical care on an outpatient basis, including intravenous diuretics, specialist assessment, monitoring and intensive drug titration, along with self-management advice and psychological support.

The University Hospital of North Staffordshire team established a day clinic for heart failure patients to provide specialist clinical care on an outpatient basis. The aim was to:

  • increase patient choice
  • reduce inpatient bed demand
  • provide care in line with national quality benchmarks
  • become clinically and cost effective.

The hospital-based clinic provided patients with care that was previously only available to inpatients, including intravenous diuretics, specialist assessment, monitoring and intensive drug titration. It also offered ongoing self-management advice and psychological support for patients and their carers.

The multidisciplinary heart failure team aimed to treat 260 patients over a 12 month period with an equal split of referrals for admission prevention and reduced length of stay. Issues that the team wanted to explore included the clinical governance considerations involved in moving the clinic to a community setting, and how the clinic could be more closely linked to primary care services to provide a seamless care pathway.

Who was involved

The clinic was set up by a multidisciplinary heart failure team and accepted referrals from primary and secondary care.


  • Nine beds removed from acute trust, generating a cost saving of £980,000.
  • Financial saving of £365,000 for the health economy based on reduction in admissions and payment of a local tariff for the clinic.

Further reading

Learning report

Shine: Improving the value of local healthcare services

February 2014
Learning report

Successes and lessons from the first two rounds of the Health Foundation’s Shine programme: annual...

About this programme


Shine 2011


This programme ran from 2011 to 2012 and awarded 14 teams with up to £75,000 for projects to find...

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