The Heart Failure Targeted Funding Programme was an NHS England initiative to improve access to heart failure specialists in the community and during a hospital admission. Over £4.4 million was invested in services nationally. This report is an evaluation of the programme.

The 2023/24 Heart Failure Targeted Funding Programme (HFTFP) was developed by the NHS England (NHSE) Clinical Policy Unit (CPU). The HFTFP provided non-recurrent indicative targeted funding of over £4.4 million to improve access to a HF specialist/specialist HF multidisciplinary team (MDT) in community settings and during admission.

The programme aims were to support local systems to work towards delivering the NHS Long Term Plan aims and the broader Cardiac Transformation Programme ambition to reduce HF 30-day readmission rates through:

• Early detection of HF in community settings
• Providing rapid access to a HF specialist/MDT during admission and implementing robust discharge planning
• Early specialist HF MDT follow-up in the community.

The NHSE CPU commissioned the NHS Strategy Unit to evaluate the use of this funding. The evaluation explored eight detailed case studies (selected from 55 projects) and developed recommendations for shaping future national funding programmes.

How heart failure services used the funding

The evaluation highlighted four main areas where funding was applied, offering valuable insights into what worked well and where challenges emerged.

Digital tools for patient monitoring

Two projects introduced digital tools for remote monitoring. The evaluation found that:

• There are significant Information Governance considerations and the time for this needs to be factored into planning.
• Implementing new digital tools takes considerable time and resource to build practitioner and patient confidence to use it, and therefore may not be suitable for a short-term project delivered at scale.

Enhancing community detection of HF

Two projects enhanced community detection of HF. The evaluation found that:

• Upskilling primary care colleagues in the detection and management of HF can create sustainable transformation, reducing the burden on hospital services and enhancing preventative measures.
• Targeted screening in primary care based on specified risk factors is likely to reduce healthcare inequalities by improving the identification of HF in underserved groups and those with multi-morbidities.

Patient education initiatives

Two projects focused on developing patient education approaches. The evaluation found that:

• Support from primary care was critical to deliver the projects, and this required a clear communications strategy and resource to deliver it.

Rapid up-titration of HF medications

Two projects developed an approach to rapid up-titration based on the STRONG-HF trial. The evaluation found that:

• Rapid up-titration supported by dedicated HF specialist nurses with a prescribing qualification may make it more efficient
• Clearly defining criteria to determine which patients are appropriate for rapid up-titration is critical to consider for similar projects.

Lessons for future national funding programmes

Although the HFTFP successfully delivered funding to over 50 projects, challenges emerged around delivery and monitoring impact. The evaluation made the following recommendations for similar national funding programmes.

Project funding

• Timescales: Two years is a more feasible time period for these kinds of projects (rather than the one-year provided)
• Funding flow: Funding should be released at the start of the financial year to prevent delays caused by local approval processes
• Staged release of funding: Phased funding can help ensure money is used effectively — for example, allocating an initial amount for set-up, with the remainder released once delivery is confirmed as ready
• Workforce planning: Services should determine whether recruitment is necessary for introducing a short-term project, or whether capacity for delivering this work could be ringfenced or secured in other ways that take less time.

Programme design

• Delivering transformation in HF care requires detailed, evidence-based plans supported by clinical, operational, and system leaders. Future schemes should include closer scrutiny of bids to assess delivery risks and mitigation plans.
• NHSE should provide structured opportunities for projects to share learning, particularly in the early stages to help overcome challenges and mitigate delays.

Monitoring the impact of funding

• National funding programmes with short timescales should prioritise delivery of interventions with an existing evidence base. These are more likely to show measurable impact within the funding cycle
• Projects testing new and innovative ideas should be supported through dedicated innovation programmes with appropriate timelines for evaluation

The HFTFP supported over 50 projects across England, providing valuable insights into how targeted investment can improve heart failure services. The evaluation makes clear that while short-term funding can spark innovation, investing more time in reviewing funding proposals to ensure projects are deliverable will make best use of the resources available. Making funding decisions based on the evaluability of the project is also recommended to demonstrate the impact of the investment.