A typical community pharmacy will dispense medicines for around 80 patients with heart failure, most of whom will also be on medication for other conditions – generally because the average age at diagnosis is 76 years. On average, a GP will look after 30 patients with heart failure and will suspect the condition in a further 10 patients each year.

Heart failure is estimated to account for one million in-patient bed days (equivalent to two per cent of all NHS in-patient bed days) and five per cent of all emergency medical admissions to hospital. The total cost of heart failure to the NHS may be more than £700 million a year, or around 1.8 per cent of the total NHS budget.

Of course in addition to the NHS costs, the disease places a significant burden on other health agencies, such as social services. Any cardiovascular disease can potentially lead to heart failure, which shows itself as clinical signs such as breathlessness, fatigue and fluid retention.

A patient’s quality of life is affected by the physical limitation imposed by the disease and the emotional problems that arise as a result. The challenge is combined with managing other co-morbidities as well as dealing with polypharmacy and potential side effects from multi-drug therapy.