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Aims Heart failure (HF) causes or complicates approximately 5% of all hospital admissions in the UK. Specialist input for patients hospitalised with HF is associated with greater adherence to guideline directed treatment, and better outcomes. However, the number and need of patients hospitalised with HF greatly outweighs the number of specialist beds and staff available. HF out-reach teams may bridge the gap between specialist and non-specialist care. We describe the first year of the Specialist Nurse-led HF Outreach service at Hull University Teaching Hospitals NHS Trust.Methods HUTH NHS trust serves a population of ~600,000 patients across two main hospitals: Castle Hill Hospital (CHH) and Hull Royal Infirmary (HRI) ( figure 1). All acute admissions come to HRI where there is one cardiology ward. We have 3 HF specialist nurses (HFSN) working 2 full-time equivalents, 0800-1600, Monday to Friday. Patients are referred to the service via bleep, phone, email, or electronic referral forms based on referral guidelines ([1] HF is the suspected primary diagnosis; [2] N-terminal pro-B-type natriuretic peptide (NT-proBNP) >2000 ng/L). Patients outside guidelines may also be reviewed. Case-finding is performed via a ‘furosemide list’ – which is produced three times per week and identifies all patients who have been given intravenous furosemide in the preceding 72 hour period. The outreach service is supported by 1.5 full time consultant cardiologists with expertise in HF. A weekly virtual multi-disciplinary-team meeting is held every Monday, with urgent email MDT discussions ad hoc. Multiple audits are performed throughout the year to assess the efficacy of the service.Results Between 01/04/2024 and 31/03/2025 the service reviewed 1223 patients, of whom 1173 met referral criteria (96%), ~490 patients per 1 FTE HFSN per year. 180 (15%) of patients were identified through case finding ( figure 2). 509 patients (42%) had HF with a reduced ejection fraction (HFREF), a further 524 patients (43%) had HF with a preserved ejection fraction, or valve disease; and 190 patients (15%) did not have in-patient echocardiography at the time of review. Approximately half of referrals (48%) came from general medical wards, only 12% of referrals came from accident and emergency, or the acute admissions unit. 35% of the patients reviewed were for patient education on cardiology wards.Conclusions HFSN-led outreach service increases the access to specialist care for patients hospitalised with HF within the first days of admission. Case load is high but manageable with adequate and timely medical support. A major challenge is failure to refer patients on admission. Strategies to increase awareness of and referrals to our service are needed.Abstract 121 Figure 1Abstract 121 Figure 2