Heart Failure Nurse Audit 2018

Heart Failure Nurse Audit Data

Heart Failure Nurse Audit Data

The Pumping Marvellous Foundation has just finished completing the first national audit of the provisioning of heart failure nurse services across the UK.

The Pumping Marvellous Foundation is beginning to release the heart failure nurse audit data to coincide with heart failure awareness week. The Foundation knows that patients and their carers repeatedly tell us about their marvellous heart failure nurse and how important they are. Indeed, the All Party Parliamentary Group inquiry into heart failure in September 2016 raised the significance of the role that is played by the heart failure nurse. At the same time, they acknowledge that there is no national definition of a heart failure specialist nurse, how many nurses there are or where these nurses work, the skills or experience that is required for the role, and just what services teams are offering. The Pumping Marvellous Foundation decided to catalyse the discussion and advocate for heart failure nurses as the patients rated them as the most important member of the heart failure MDT. We also know of the benefit they bring to patient clinical outcomes and the prevention of hospital readmissions. We decided with a hands off educational grant from Boston Scientific, who had the foresight to see our need to design, deliver and disseminate our findings through the Heart Failure Nurse Audit.

Lynda Blue who sits on our clinical team and was the first heart failure specialist nurse in the UK, says

‘It is important in this economic climate with stretched NHS Services that Heart Failure Nurse Specialists audit their role/service on a regular basis to ensure their roles are both sustained and to support a further business case if additional nurses are required for the service. The audit data collected should be able to demonstrate the positive impact the role has on a HF patient’s journey’

Over the coming weeks we will be revealing some of the heart failure nurse audit data to demonstrate the need to invest in, not just heart failure but specifically heart failure nurses.

Later in the month we will be launching our brand new platform which will be available to all stakeholders, especially patients so they can find out where these heart failure nursing teams exist and what services they offer.

Here is the first snapshot of data –

Heart Failure Nurse Audit 2018

Visit PMTVLive – The Pumping Marvellous Foundations YouTube channel
Visit Heart Failure Aware – The Pumping Marvellous Foundations awareness page

If you need help and you have heart failure or you are a carer of family member with heart failure come and join our marvellous heart failure community on Facebook

To learn about heart failure go to this link

Need patient information – visit this link to our marvellous library

Simple £15 Blood Test

Simple £15 Blood Test

Simple £15 Blood Test

A father claims his GP failed to give him a simple £15 blood test which could have saved him from suffering heart failure at the age of 39.

Nick Hartshorne-Evans spent five weeks visiting his doctor with breathlessness and swollen ankles – classic symptoms of the condition – but was sent away with cough medicine and antibiotics but no simple £15 blood test.

It was only when he found himself struggling to walk and he was rushed to A&E that medics discovered his heart was failing, likely as a complication from Swine Flu. The entrepreneur, now 47, has hit out at the “postcode lottery” in testing for levels of a certain protein that are higher than normal when you have heart failure after hearing from scores of patients who had similar experiences but not having experienced this simple £15 blood test.

Heart failure affects at least 900,000 adults in the UK. Campaigners argue the test should be made available to all hospitals and GPs.

Experts say this would speed up diagnosis and save the health service millions of pounds each year. Heart failure accounts for a total of 1 million inpatient bed‑days – 2 per cent of all NHS inpatient bed-days – and 5 per cent of all emergency medical admissions to hospital, according to the National Institute for Health and Clinical Excellence (NICE). Hospital admissions because of the condition are projected to rise by 50 per cent over the next two decades, largely as a result of the ageing population. According to NHS Improvement, testing for brain natriuretic peptide (BNP), which costs from £15-£25, can be used to confirm or rule out heart failure with 98 per cent accuracy and is more useful than an electrocardiogram (ECG). BNP is a hormone released by the heart when the ventricles are stretched. ‘Terrifying’ Yet a survey of cardiac networks by the organisation in 2009 showed that only 46 per cent of PCTs provided such testing for GPs in primary care.

In a recent survey conducted by the Pumping Marvellous Foundation, 22 per cent of areas had no access to natriuretic peptide testing.

Mr Hartshorne-Evans, who set up the charity The Pumping Marvellous Foundation to raise awareness of the issue, said being diagnosed with heart failure so young was “terrifying”. He said: “Those two words really hit you. You feel dazed and confused, I felt like I had done ten rounds with Mohammad Ali. We know that if I’d have had that simple test that I could have been prevented from suffering heart failure.” And while the father to two teenage girls has a good prognosis following an operation in 2013, he is keen to prevent anyone else going through what he has. “I am lucky in that I was fairly young and fit and I had outstanding care after my diagnosis,” he said. “But many won’t be so lucky, especially if they’re older. “We conducted a survey of our members of the charity and out of 170 respondents, 65 per cent had never heard of the BNP test which suggests that they never had it. “Heart failure affects people of so many levels – physically, emotionally and financially. The cost to the NHS is astounding too. Potentially thousands of lives could be saved if there is more access and awareness of this test.”

Read more at: https://inews.co.uk/news/health/exclusive-a-simple-15-blood-test-could-have-saved-me-from-heart-failure-says-father/

Visit PMTVLive – The Pumping Marvellous Foundations YouTube channel
Visit Heart Failure Aware – The Pumping Marvellous Foundations awareness page

If you need help and you have heart failure or you are a carer of family member with heart failure come and join our marvellous heart failure community on Facebook

To learn about heart failure go to this link

Need patient information – visit this link to our marvellous library

Heart Failure Infographic

Heart Failure Infographic

Heart Failure Infographic makes Heart Failure clearer for everyone

Heart failure is a syndrome caused by many different reasons. We have produced this heart failure infographic to help people understand –

  • What it is
  • What are the common symptoms of heart failure
  • What are the common causes of heart failure
  • Some facts and figures around the impact of heart failure
  • Some of the positive steps we can take to make living with heart failure better

The patients tell us what we need to do

The patients in our online communities – our closed community support group on facebook and our heart failure page on facebook told us there appeared to be a lack of good quality understandable information about heart failure in the UK. With their help we developed a list of priorities and showcased them in an heart failure infographic.

You can download the infographic here or open up as a pdf. We encourage you to share this page and help the Pumping Marvellous Foundation build awareness of what heart is, it’s causes and symptoms and it’s impact. Most importantly what we and others should be doing about making lives for heart failure patients better.

If you know someone with heart failure give them a gift and tell them about the Pumping Marvellous Foundation. Telling them about the support available is important.

 

Marvellous Awards 2018 - Heart Failure specialists recognised

Marvellous Awards 2018 – Heart Failure specialists recognised

Marvellous Heart Failure Awards 2018

Heart Failure Health Care Professionals recognised for marvellous quality of care by the UK’s Heart Failure charity. The Pumping Marvellous Foundation awards UK Health Care Professionals for being simply marvellous.

Preston, Lancashire, December 2017 –

Health Care Professionals throughout the UK have been recognised and honoured by patients for their exceptional quality of care and treatment. Sponsored by The Pumping Marvellous Foundation, this award acknowledges the value that these Health Care Professionals bring to the treatment of Heart Failure, improving patient outcomes throughout the UK. Measured by the individual patients’ experience, this award reflects the direct impact these three outstanding Health Care Professionals have in the local community, producing the highest standards of care for their patients.
2018.

The winners are:-

Matthew Sunter – Heart Failure Nurse Specialist – Based at St Georges Hospital in Tooting, London – nominated by heart failure patient Bev Keddo
Dr Kate Gatenby – Cardiologist – Based at Leeds General Infirmary, Leeds, West Yorkshire – nominated by heart failure patient Rich Cleverley
Sarah Mills – Heart Failure Nurse Specialist – Based at Kidderminster Hospital, Kidderminster – nominated by heart failure patient Steve Squire

Cardiac Team of the Year goes to – The Golden Jubilee National Hospital, Clydebank, Scotland – Nominated by heart failure patient Stephen Taylor

As the representative of the UK Heart Failure patients’ voice, The Pumping Marvellous Foundation emphasises the importance of the patient perspective in recognising and rewarding Health Care Professionals.

“We are delighted that our patient community has chosen these heart failure specialists to receive these yearly awards from the charity. It’s so important that patients and their families can work with and operate as a team with their Health Care Professional. A superb achievement and all three of the Health Care Professionals and the team at the Golden Jubilee should be proud of themselves”, explains Nick Hartshorne Evans, Founder and CEO of The Pumping Marvellous Foundation.

Awards are currently being received by Health Care Professionals this week alongside a personalised commendation letter explaining the reasons behind their selection.

“Congratulations to all the winners. We recognise that there are so many fantastic Health Care Professionals out there and to all those who haven’t won, I’d like to take this opportunity to thank you for all your amazing work,” says Angela Graves, Clinical Lead of The Pumping Marvellous Foundation.

Ends – For more information please contact The Pumping Marvellous Foundation +44 (0) 1772 796542 or +44 (0) 7854 407050, hearts@pumpingmarvellous.org

Notes for Editors

The Pumping Marvellous Foundation (PMF) is the UK’s patient led Heart Failure charity. It was founded by a heart failure patient whose experiences whilst rehabilitating have shaped the Foundation’s goals and principles of a patient-centric charity focused on improved patient outcomes.

 

Heart Failure affects 900,000 people in the UK – https://www.nice.org.uk/guidance/cg108/chapter/Introduction

 

Heart failure is debilitating and outcomes are poor: 5 year survival rate is worse than breast or prostate cancer – http://circoutcomes.ahajournals.org/content/circcvoq/early/2010/10/05/CIRCOUTCOMES.110.957571.full.pdf

 

30-40% of those diagnosed with heart failure die within the first year – http://heart.bmj.com/content/83/5/505.long

 

Heart failure is a major cost to the NHS. It is a leading cause of hospital admission in over 65s – https://www.nice.org.uk/guidance/cg187

 

Earlier Access to New Therapies in the NHS

Earlier Access to New Therapies in the NHS

PATIENTS TO GET BREAKTHROUGH TECHNOLOGIES AND TREATMENTS UP TO FOUR YEARS EARLIER THROUGH NEW ACCELERATED ACCESS SCHEME

Does this mean earlier access? – A new, fast-track route into the NHS for “breakthrough” medicines and technologies has been announced by the Government in a bid to dramatically speed up the time it takes for patients to benefit from ground-breaking products for conditions such as cancer, dementia and diabetes.

From April 2018, the new Accelerated Access Pathway will mean selected products with the greatest potential to change lives could be available up to four years earlier by reducing the time taken to negotiate the evaluation and financial approvals necessary before the NHS can purchase them.

Under the scheme, each year a number of products would receive “breakthrough” designation, unlocking a comprehensive package of support that will allow firms to accelerate clinical development and benefit from a fast-track route through the NHS’s approval processes.

Health Minister, Lord O’Shaughnessy, said:

“I want the UK to be the best place in the world to develop new drugs and medical technology – but despite the innovation happening here, our uptake in the NHS can be too slow.

“Today’s new measures will not only benefit patients by improving how quickly and easily we can get innovative products from the lab to the bedside, but will guarantee future collaboration between the life sciences sector and the NHS post-Brexit – benefiting the British economy and creating jobs.”

Sir Andrew Witty, former chief executive of GlaxoSmithKline will lead the Accelerated Access Collaborative, which will make decisions on which products should be granted access to the pathway, drawing on advice from patients, clinicians and industry.

In return, life sciences firms will be expected to deliver additional value for the taxpayer, with a new Strategic Commercial Unit being created within NHS England to help negotiate cost effective deals with innovators.

Sir Andrew Witty, Chair of the Accelerated Access Collaborative, said:

“Patients, scientists and the UK economy will all benefit from the positive steps outlined by the government today.

“The opportunity to ensure the NHS gets rapid access to cost effective breakthrough technologies is vitally important, and I’m delighted to help lead the effort to deliver this.”

UK Bio Industry Association CEO, Steve Bates, said:

“This new fast track pathway should both speed up access for NHS patients to the latest therapies and help to ensure the UK remains a globally attractive cluster in which to start, scale and grow leading life sciences businesses.

“Sir Andrew Witty’s leadership of the Accelerated Access Collaborative means significant industrial insight into the selection process for products able to access this new accelerated route to market.”

The Government is also providing an £86 million funding package to help innovators of all sizes to access the NHS market, and help ensure that these products get to the patients that need them.

This includes:

  • More support for small and medium-sized enterprises to help them build a stronger evidence base for their products, with £35 million over four years to help SMEs with digital products, and a £6 million scheme to support medtech, diagnostics and pharmaceutical products.
  • £6 million to support clinicians to use new treatments and technologies in everyday practice.
  • £39m to encourage grassroots adoption and uptake of new medical technologies, driven by 15 Academic Health Science Networks which are responsible for identifying high potential products, supporting their adoption regionally and sharing lessons across the wider NHS.

A Full Press release by the UK Government in response to the Accelerated Access Review can be found here

The Pumping Marvellous Foundation response

So does this mean earlier access to the latest therapies?

Earlier access through the new Accelerated Access Scheme to innovative therapies seems to demonstrate  a firm commitment to better patient access with the extension of the medical score card system now including medical technologies which is an important area of progressive treatments for people with heart failure.

The area of concern and where this may just be a big sound bite is that it seems –

  • Light on detail
  • Reimbursement models and incentives are not clear
  • How will the Accelerated Access Scheme interact with everyday life in the health system especially with the remodelling throughout the system

These are fundamental questions that need to be answered before the scheme becomes real.

heart failure's decade?

Heart Failure’s Decade?

Is this Heart Failure’s Decade?

Heart Failure has been the classic “Cinderella Syndrome”, under invested, under resourced. The vast majority of the public don’t know what it is. Until the Pumping Marvellous Foundation, formed in 2013 as a registered charity, there has never been a successful orchestrated attempt to advocate for the patient. Naturally you would stand back and say, “Aren’t we doing this for the patient?” Is this Heart Failure’s Decade?

The phrase used by so many in the health system is “the patient voice”. I hear it so many times it keeps me up at night. To be honest I don’t really know what it means.

Is this Heart Failure’s Decade? The patient voice

For too long the “patient voice” has been a tick box for many stakeholders to demonstrate they are in “working in alignment” with the patient needs. Heart Failure has the potential to be the straw that broke the camel’s back.

Is this Heart Failure’s Decade? Scale of the challenge

Around 900,000 people in the UK will be living with heart failure. The condition is debilitating and has a significant physical, psychological, social impact on people lives, and that of their families. However, the impact is further widespread than the micro health economy. It impacts macro economies. Outcomes are poor. The survival rate is worse than prostate or breast cancer. It is suggested that 30-40% of people being diagnosed with it die in the first year; the statistics go on and on. How much evidence do you need: “we must do better.” Heart failure is one of the NHS’s big red flags.

Good news

There has been some good news. Only recently the National Heart Failure Audit, which looks at hospital admissions in the NHS, saw a drop in the mortality rate, not enough, but it’s in the right direction. It also seems that the new treatment pipeline is swollen with opportunity. The challenge is to get it through the regulatory bodies into the hands of the NHS quicker.

Collaboration

Amid all the roller coaster statistics I believe we have turned a corner. Stakeholders are collaborating, producing forward momentum. Personally, I don’t think we have reached our peak yet. Ensuring that the patient is not only at the centre of all we do, but is out there in a leadership role, collaborating and shaping what the future holds. So is this heart failure’s decade?

Population insights

Instead of getting individual patient insights, healthcare professionals get this every day, I believe we should be talking to vast populations of patients, delivering insights back into researchers, academics, healthcare professionals, NICE, the Department of Health and companies. Why? Because your customers can help you make better decisions that affect them.

Talented energetic people

Coming from such a poor position things can only get better for those living with Heart Failure. There are bright, committed and talented people out there in heart failure land who are making a difference, I know many of them and the patients need to support them, as they need to support the patients, which they do daily. Heart failure has an opportunity to be shaped naturally by the many hundreds of thousands of patients insights informing people in the know what patients need. I also believe there is a movement, a ground swell of optimism from patients that needs “bottling” and distributing to those who make decisions. Those in the know need not think it’s a “genie” in the bottle, they need to believe in the value of those insights. The challenge of heart failure is bigger than those in the know. We not only need to deliver this bottle but we need to validate their understanding. This is the role of the patient group, this is what we do.

The Pumping Marvellous Foundation

The Pumping Marvellous Foundation not only works to support the many heart failure patients in the UK with patient information delivered to over 160 NHS heart failure teams in the UK, but also provides the socio-psychological support people need; it works with thousands of patients and family members to build marvellous insights through its social media channels, which are being driven to those in the know. Every time I get invited to speak at a conference where do I go to get my presentation content? The patient community of course, therefore my presentations reflect the needs of the many, not just one person’s opinion.

Nick Hartshorne-Evans
Founder and CEO of the Pumping Marvellous Foundation

Some useful links for you

Our “Marvellous Guides” – download them for useful information on how to live better with heart failure

Learn about about medicines for heart failure

See our YouTube channel PMTVLive

Join our patient community on Facebook

Clinical Management of Heart Failure

Clinical Management of Heart Failure

Clinical Management of Heart Failure in Europe

A new report out focussing on the state of play in Europe around the clinical management of heart failure has just been published by the Heart Failure Policy Network. The group is an independent, multidisciplinary group working to raise awareness of heart failure across Europe.

It identifies many policy priorities across the continent of Europe. The good, the bad and the ugly. The state of play examining the clinical management of heart failure is important. People diagnosed with heart failure deserve the very best treatments. This is vital to ensure that people pursue the very best quality of life. This can be coupled with determined self-management.

The crux of the report clearly identifies a simple theme. We know what to do but we just aren’t doing it. This document will provide stakeholders in heart failure with a clear set of tools. Tools that can be taken to the few who can change policy. This will make life better for people and their families managing their heart failure.

These policy documents are very useful to help stakeholders create conversations with policy makers and politicians at a national level. The question for the Pumping Marvellous Foundation is “when do we see the action”. The challenge is everybody is producing great content but when do we put that content into gear and drive the agenda.

Heart failure seems to have a very fractionated infrastructure across Europe where connecting the stakeholders to documents like this and working as one voice enables change. We could learn a lot from the cancer movement around pooling action and getting results for the benefit of the patient and their families.

Read the report click here

You can view the Heart Failure Policy Network here to see other work they do link to website

To find out more about what we do please click here for further information

2017 “Marvellous Awards” Announced

Patients identify heart failure specialists for the Marvellous Awards 2017″

Preston, Lancashire, December 2016 – Health Care Professionals throughout the UK have been recognised and honoured by patients for their exceptional quality of care and treatment. Sponsored by The Pumping Marvellous Foundation, this award acknowledges the value that these Health Care Professionals bring to the treatment of Heart Failure, improving patient outcomes throughout the UK. Measured by the individual patients’ experience, this award reflects the direct impact these eight outstanding Health Care Professionals have in the local community, producing the highest standards of care for their patients.

As the representative of the UK heart failure patients’ voice, The Pumping Marvellous Foundation emphasises the importance of the patient perspective in recognising and rewarding health care professionals.
“We are delighted that our patient community has chosen such worthy winners to receive these yearly awards from the charity. It’s so important that patients and their families can work with and operate as a team. A superb achievement and all eight of the Health Care Professionals should be proud of themselves”, explains Nick Hartshorne Evans, Founder and CEO of The Pumping Marvellous Foundation.
Awards have been received by Health Care Professionals this week alongside a personalised commendation letter explaining the reasons behind their selection.
“Congratulations to all the winners. We recognise that there are so many fantastic Health Care Professionals out there and to all those who haven’t won, I’d like to take this opportunity to thank you for all your amazing work,” says Angela Graves, Clinical Lead of The Pumping Marvellous Foundation.

The Winners

Vicky Baines, Senior Cardiac Rehab Sister who works at County Hospital, Stafford, Staffordshire

Carys Barton, a Heart Failure Nurse for Guys and St Thomas NHS Foundation Trust, London

Dr Stephen Page, Consultant Cardiologist who works at Leeds General Infirmary, West Yorkshire

Jan Rayner-Barton, Heart Failure Specialist Nurse who works at the Heartlands Hospital in Solihull, Birmingham, West Midlands

Dineo Raeleng, Heart Failure Specialist Nurse who works at the Heartlands Hospital in Bordesley Green, Birmingham, West Midlands

Tim Dent, Senior Genetics Nurse who works at the John Radcliffe Hospital, Oxford, Oxfordshire

Toni Weldon, Heart Failure Specialist Nurse who works at Rochdale Infirmary, Rochdale, Lancashire

Professor Andrew Clark, Consultant Cardiologist at Castle Hill Hospital, Hull, East Riding

ADD YOUR SUPPORT BY CLICKING HERE!

 

HO HO HOPE for Heart Failure Twibbon
Add a HO HO HOPE for Heart Failure Twibbon to your social media profile to support HF patients

Entresto (sacubitril valsartan) recommended by CHMP for EU approval

Entresto (sacubitril valsartan) recommended by CHMP for EU approval

A positive review puts Entresto in a position to be approved for heart failure with reduced ejection fraction by the end of 2015 in the EU.

Entresto (sacubitril valsartan) recommended by CHMP for EU approval

Press Release Novartis – Frimley

Novartis announced today that the Committee for Medicinal Products for Human Use (CHMP) has adopted a positive opinion for Entresto™ (sacubitril valsartan). Pending final approval by the European Commission (EC), Entresto (sacubitril valsartan), previously known as LCZ696, will be licensed for use in the UK for the treatment of adult patients with symptomatic chronic heart failure and reduced ejection fraction (HFrEF).

“Despite widespread use of available treatments and implementation of NICE guidelines, outcomes remain poor for those diagnosed with heart failure. The CHMP’s endorsement of Entresto brings hope to heart failure patients in the UK,” said Hugh O’Dowd, General Manager at Novartis UK & Ireland.

The CHMP’s decision, which follows previous US and Swiss approvals, is based on results from the 8,442-patient PARADIGM-HF study in patients with HFrEF, which was stopped early when it was shown Entresto (sacubitril valsartan) significantly reduced the risk of cardiovascular death versus ACE-inhibitor enalapril1. At the end of the study patients who were given Entresto (sacubitril valsartan) were more likely to be alive and less likely to have been hospitalised for heart failure than those given enalapril. Analysis of safety data showed that Entresto (sacubitril valsartan) had a similar tolerability profile to enalapril.

“The striking results in the PARADIGM-HF trial led me to believe that, once approved, LCZ696 could quickly replace what has been the bedrock treatment for more than 20 years, ACE-inhibitors,” said Professor John McMurray of the University of Glasgow and one of two Principal Investigators. “Thousands of lives could be extended and hospital admissions prevented with LCZ696’s unique ability to boost natriuretic peptides, heart-helpful hormones, while simultaneously inhibiting the RAAS system.”

Heart failure is a highly debilitating, life-threatening condition in which the heart cannot pump enough blood around the body because the muscles of the heart become too weak or too stiff to work properly2. As a consequence, patients face a high risk of death, repeated hospitalisations and symptoms such as breathlessness, fatigue and fluid retention that significantly impact quality of life. Heart failure affects around 550,000 people in the UK3 and costs the NHS about £2.3bn a year4. Even though so many people live with heart failure, most fail to recognise the symptoms, meaning many are misdiagnosed or incorrectly attribute the signs to growing older.

Early this month, Entresto (sacubitril valsartan) was given a positive scientific opinion under the Medicines and Healthcare products Regulatory Agency (MHRA) Early Access to Medicines Scheme (EAMS) for patients with significant unmet medical need. This allows Entresto (sacubitril valsartan) to be made available to eligible patients before the EC makes a final European licensing decision based on the recommendations of the CHMP.

End

For further information – Link to Novartis press release 

LCZ696 (sacubitril valsartan) available to NHS through EAMS

LCZ696 (sacubitril valsartan) available to NHS through EAMS

New heart failure medicine LCZ696 (sacubitril valsartan) is to be made available to the NHS under the Early Access to Medicines Scheme (EAMS).

This is a good day for heart failure patients after Bayers announcement earlier in the day

Novartis LCZ696 (sacubitril valsartan) press release

Novartis’s LCZ696 (sacubitril valsartan) is the first non-oncology drug to gain EAMS status under the Medicines and Healthcare products Regulatory Agency’s (MHRA) programme for innovative medicines. Novartis will provide LCZ696 (sacubitril valsartan) to the NHS for eligible patients enrolled in EAMS.

Frimley, September 1, 2015 – Novartis today announced that its investigational heart failure treatment LCZ696 (sacubitril valsartan) has been given a positive scientific opinion under the Medicines and Healthcare products Regulatory Agency (MHRA) Early Access to Medicines Scheme (EAMS) for patients with significant unmet medical need. This allows LCZ696 (sacubitril valsartan) to be made available to eligible patients before a final European licensing decision is made.

It is the first time a drug not intended to treat cancer has been recognised under EAMS.

Heart failure affects around 550,000 people in the UK and costs the NHS about £2.3bn a year1,2 . Heart failure has a poor prognosis: around 60% of patients diagnosed with heart failure die within five years3 and survival rates are worse than certain cancers, such as breast and prostate4 .

“This is great news for patients with heart failure. The EAMS positive scientific opinion ensures patients with this debilitating condition can access sacubitril valsartan earlier than expected,” said Prof Iain Squire, Professor of Cardiovascular Medicine, University of Leicester and Honorary Consultant Physician, University Hospitals of Leicester NHS Trust. “Based on what we’ve seen in clinical trials, access to this new medicine will help patients live longer and keep them out of hospital, compared to currently available treatment.”

The MHRA has given LCZ696 (sacubitril valsartan) a positive scientific opinion based on the high level of unmet need in heart failure and data from the PARADIGM-HF study that showed LCZ696 (sacubitril valsartan) significantly improved patient outcomes compared to the current gold standard treatment, including a reduction both in cardiovascular deaths and hospitalisations due to heart failure5 .

Hugh O’Dowd, General Manager at Novartis UK & Ireland, said: “Despite widespread use of available treatments and implementation of NICE guidelines, outcomes remain poor for those diagnosed with heart failure. So it’s very encouraging that LCZ696 (sacubitril valsartan) will be available via the EAMS, allowing patients in the UK with this debilitating condition to gain benefit. We are working closely with the NHS to ensure eligible patients have rapid access under the scheme while we await the final European licensing decision.” 2/4

Life Sciences Minister George Freeman said: “Heart failure is a devastating condition that affects hundreds of thousands of people in the UK, so I am delighted that patients will now be able to access this life-enhancing treatment. The UK’s Early Access to Medicines Scheme is making a real difference in speeding up access to drugs and almost 300 patients with complex conditions have already received innovative treatments earlier than they otherwise would have thanks to the scheme.

Media contacts Novartis Media Relations Michael Amos Novartis Communications UK Ltd. Tel: +44 7920 467679 (Press Office) Email: press.office@novartis.com

Aurora Healthcare Communications Claire Eldridge Managing Director +44 20 7148 4179 (direct) +44 7736 277 106 (mobile) claire.eldridge@auroracomms.com Maya Anaokar Account Director +44 207 148 4170 +44 7976 835 658 (mobile) maya.anaokar@auroracomms.com

About – LCZ696 (sacubitril valsartan) in heart failure LCZ696 (sacubitril valsartan) is an ARNI (angiotensin receptor neprilysin inhibitor) and has a unique mode of action, which is thought to reduce the strain on the failing heart6 . It harnesses the body’s natural defences against heart failure, simultaneously acting to enhance the levels of natriuretic and other endogenous vasoactive peptides, while also inhibiting the renin-angiotensin-aldosterone system (RAAS)6 .

In the Phase III trial, PARADIGM-HF, in patients with heart failure with a reduced ejection fraction, patients on LCZ696 (sacubitril valsartan) were significantly less likely to die from cardiovascular causes than those on the comparator, ACE-inhibitor enalapril5 . In PARADIGM-HF, LCZ696 (sacubitril valsartan) 5 :

 Reduced the risk of dying from a cardiovascular cause by 20% (p=0.00004) vs enalapril

 Reduced heart failure hospitalisations by 21% (p=0.00004) vs enalapril

 Reduced the risk of dying from any cause by 16% (p=0.0005) vs enalapril

 Overall there was a 20% risk reduction on the primary endpoint, a composite measure of CV death or heart failure hospitalisation (p=0.0000002). Patients’ reports of how they felt and doctors’ assessments of disease severity were also significantly better with LCZ696 (sacubitril valsartan) than enalapril7 .

About the Early Access to Medicines Scheme The Early Access to Medicines Scheme (EAMS), which is run by the Medicines and Healthcare products Regulatory Agency (MHRA), aims to give patients with life threatening or seriously debilitating conditions access to medicines that do not yet have a marketing authorisation when there is a clear unmet medical need.

Under the scheme, the MHRA gives a scientific opinion on the benefit/risk balance of the medicine, based on the data available when the EAMS submission is made. The opinion lasts for a year and can be renewed. The scheme is voluntary and the opinion from MHRA does not replace the normal licensing procedures for medicines. 3/4

The scientific opinion is provided after a two-step evaluation process: the promising innovative medicine (PIM) designation and then the early access to medicines scientific opinion. LCZ696 (sacubitril valsartan) was awarded the PIM designation in April 2015, based on the results of the PARADIGM-HF trial. More information is available on the MHRA website at https://www.gov.uk/apply-for-the-early-access-to-medicines-scheme eams.

About heart failure

Around 550,000 people in the UK have heart failure1 ; both the incidence and prevalence of heart failure increase with age4 . The risk of heart failure is higher in men than in women but there are more women than men with heart failure due to population demographics4 .The most common cause of heart failure in the UK is coronary artery disease4 . Heart failure has a poor prognosis: 60% of patients diagnosed with heart failure die within five years 3 . Survival rates are similar to those for cancer of the colon, and worse than those from cancer of the breast or prostate4 . Heart failure has a major impact on quality of life and is associated with mood disorders4 .

On average, a general practitioner looks after 30 patients with heart failure and will diagnose ten new heart failure patients annually4 . Heart failure accounts for a total of 1 million inpatient bed days – 2% of all NHS inpatient bed-days – and 5% of all emergency medical admissions to hospital4 . It is estimated that the total annual cost of heart failure to the NHS is around 2% of the total NHS budget: approximately 70% of this total is due to the costs of hospitalisation4 . As well as NHS costs, heart failure also places a burden on other agencies such as social services and the benefits system, and of course on the patients with heart failure and their families and caregivers4 .

Disclaimer The foregoing release contains forward-looking statements that can be identified by words such as “being investigated,” “thought,” “plans,” “growing,” or similar terms, or by express or implied discussions regarding potential marketing approvals for LCZ696 (sacubitril valsartan), or regarding potential future revenues from LCZ696 (sacubitril valsartan). You should not place undue reliance on these statements. Such forwardlooking statements are based on the current beliefs and expectations of management regarding future events, and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialise, or should underlying assumptions prove incorrect, actual results may vary materially from those set forth in the forward-looking statements. There can be no guarantee that LCZ696 (sacubitril valsartan) will be approved for sale in any market, or submitted for approval in any additional markers, or at any particular time. Neither can there be any guarantee that LCZ696 (sacubitril valsartan) will be submitted or approved for any additional indications or labeling in any market, or at any particular time. Nor can there be any guarantee that LCZ696 (sacubitril valsartan) will be commercially successful in the future. In particular, management’s expectations regarding LCZ696 (sacubitril valsartan) could be affected by, among other things, the uncertainties inherent in research and development, including unexpected clinical trial results and additional analysis of existing clinical data; unexpected regulatory actions or delays or government regulation generally; the company’s ability to obtain or maintain proprietary intellectual property protection; general economic and industry conditions; global trends toward health care cost containment, including ongoing pricing pressures; unexpected manufacturing issues, and other risks and factors referred to in Novartis AG’s current Form 20-F on file with the US Securities and Exchange Commission. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forwardlooking statements contained in this press release as a result of new information, future events or otherwise. 4/4

About Novartis Novartis provides innovative healthcare solutions that address the evolving needs of patients and societies. Headquartered in Basel, Switzerland, Novartis offers a diversified portfolio to best meet these needs: innovative medicines, eye care and cost-saving generic pharmaceuticals. Novartis is the only global company with leading positions in these areas. In 2014, the Group achieved net sales of USD 58.0 billion, while R&D throughout the Group amounted to approximately USD 9.9 billion (USD 9.6 billion excluding impairment and amortization charges). Novartis Group companies employ approximately 120,000 fulltime-equivalent associates. Novartis products are available in more than 180 countries around the world. For more information, please visit http://www.novartis.com.

1 British Heart Foundation. At-home treatment for heart failure patients eases burden for families and for NHS. 9 June 2015. Available at: https://www.bhf.org.uk/news-from-the-bhf/newsarchive/2015/june/at-home-treatment-for-heart-failure-patients-eases-burden-for-families-and-fornhs Last accessed August 2015

2 NHS Choices. The NHS in England. About the National Health Service (NHS). January 2015. Available at http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx Last accessed August 2015.

3 Sutherland K. Bridging the quality gap: heart failure. 2010. London. Health Foundation. Available from: http://www.health.org.uk/sites/default/files/BridgingTheQualityGapHeartFailure_0.pdf Last accessed August 2015 4 National Clinical Guideline Centre. Chronic heart failure: the management of chronic heart failure in adults in primary and secondary care. 2010. London: National Clinical Guideline Centre. Available from: http://guidance.nice.org.uk/CG108/Guidance/pdf/English Last accessed August 2015

5 McMurray JJV, et al. Angiotensin-Neprilysin Inhibition versus Enalapril in Heart Failure. N Engl J Med.2014;371:993-1004

6 Langenickel TH and Dole WP. Angiotensin receptor-neprilysin inhibition with LCZ696: a novel approach for the treatment of heart failure. Drug Discov Today Ther Strateg. 2012;9:e131-e139

7 Packer M, et al. Angiotensin-Neprilysin Inhibition and Clinical Progression in Surviving Patients with Heart Failure Circulation.2015;131:54-61