{
  "abstract": "Introduction The Cardiac Ambulatory Unit (CAU), a Cardiologist supported nurse-led service at Royal Blackburn Teaching Hospital (RBH), is an initiative that launched in July 2024 to provide ambulatory care to cardiac patients. With over 1.1 million hospital admissions per year in the UK attributable to cardiovascular disease, measures that reduce the burden on community and inpatient cardiac services are invaluable. 1 The service accepts referrals from Cardiologists and Cardiac specialist nurses and is responsible for managing a wide variety of acute and chronic cardiovascular conditions.Methods This was a retrospective service evaluation of activity within the CAU at RBH over a 13-month period from July 2024 to July 2025. Patient encounters were identified using routinely collected CAU data and classified according to the primary reason for attendance. Avoided inpatient admission days were estimated based on episodes of ambulatory intravenous (IV) furosemide administration. Avoided primary care encounters were estimated for activities commonly delivered in community settings, including blood tests, blood pressure monitoring and medication administration. Financial impact was estimated using locally agreed Trust tariffs applied to CAU activity to calculate revenue generated over the period.Results There were 713 patient encounters with an increase in monthly encounters over time, with 7 in month 1, compared to 102 in month 13 ( figure 1). The most frequent attendance reason was for blood tests (n=297), IV furosemide administration (n=181) and review by the Heart Failure Specialist Nurse (n=52), with remaining encounters comprising subcutaneous inclisiran administration (n=51), ECG monitoring (n=35), IV iron administration (n=31), blood pressure monitoring (n=5), transthoracic echocardiograms (n=3) and other miscellaneous activities (n=58) (figure 2). An estimated 181 inpatient admission days and 353 primary care encounters were avoided. 47 patients were subsequently re-admitted to hospital in the 30 days following a CAU attendance; 28 were readmitted for cardiac causes (3.9%), with 13 of the 47 patients admitted directly from CAU thereby avoiding an Emergency Department attendance. The estimated revenue generated by the Cardiac Ambulatory Unit for the Trust over 13 months was £1,083,802.Conclusions Introduction of the CAU in this centre has been a safe and effective way of reducing hospital admissions, lowering inpatient stay duration, and minimizing the burden of acute care follow-up on primary care. Improved patient-centred outcomes are accompanied by system-level cost and time savings. In the current climate of strictly rationed health resources the CAU represents a well justified investment. Uptake of this service is rising dramatically, and current benefits are only likely to increase with this. Future directions include streamlining the referral process, increasing capacity and improving the service’s primary-secondary care interface.Reference British Heart Foundation. Heart and Circulatory Disease Statistics 2024: 2024 Compendium (v3) [Internet]. London: British Heart Foundation; 2024 Oct 16 [cited 2026 Jan 14].Abstract 339 Figure 1Growth of patient encounters in CAU over timeAbstract 339 Figure 2Breakdown of encounter activity, %",
  "authors": [
    {
      "affiliations": [
        "Royal Blackburn Teaching Hospital, Blackburn, United Kingdom"
      ],
      "name": "Callum Blunt"
    },
    {
      "affiliations": [
        "Royal Blackburn Teaching Hospital, Blackburn, United Kingdom"
      ],
      "name": "James Baudry"
    },
    {
      "affiliations": [
        "Royal Blackburn Teaching Hospital, Blackburn, United Kingdom"
      ],
      "name": "Katie McGlynn"
    },
    {
      "affiliations": [
        "Royal Blackburn Teaching Hospital, Blackburn, United Kingdom"
      ],
      "name": "Doris Robinson"
    },
    {
      "affiliations": [
        "Royal Blackburn Teaching Hospital, Blackburn, United Kingdom"
      ],
      "name": "Shameen Malik"
    },
    {
      "affiliations": [
        "Royal Blackburn Teaching Hospital, Blackburn, United Kingdom"
      ],
      "name": "Kanarath Balachandran"
    },
    {
      "affiliations": [
        "Royal Blackburn Teaching Hospital, Blackburn, United Kingdom"
      ],
      "name": "Jincy Santhosh"
    },
    {
      "affiliations": [
        "Royal Blackburn Teaching Hospital, Blackburn, United Kingdom"
      ],
      "name": "Sumaiyah Asvat"
    },
    {
      "affiliations": [
        "Royal Blackburn Teaching Hospital, Blackburn, United Kingdom"
      ],
      "name": "Samantha Youds"
    }
  ],
  "title": "339 Reducing admissions and optimising care pathways: the role of the cardiac ambulatory unit at royal blackburn teaching hospital",
  "uid": "b98af597-b8da-5bf2-9ebe-0decf8db45e9"
}