Heart Valve Disease and Heart failure contribute to 25% of hospital emergency admissions while heart failure alone has become one of the most common causes for hospitalisation in people over the age of 65. The burden of disease is likely to be high in a multi-ethnic community but there is a paucity of data. Management of heart valve disease requires appropriate surveillance and timely surgery. Similarly heart failure management requires treatment with medications aimed at slowing prevention of symptoms and preventing premature death. The NHS long term plan priorities early detection and treatment of valve disease and heart failure in order to reduce the burden on emergency services and improve the health of the population.

Diagnosis is made using cardiac ultrasound, however staff with the required skills-set are critically limited in the community.

The investigators will train non-expert staff within primary care to perform abbreviated cardiac ultrasound to detect heart valve disease or heart failure. This will be opportunistic scanning to reduce healthcare footfall.

All scans will be reviewed by an expert and the investigators will use the anonymised data to develop machine learning tools to begin working with academic partners to develop tools that can improve the reliability of diagnosis from ultrasound.

The investigators hope to identify the proportion with the above conditions in a multi-ethnic community and assess the feasibility of developing a program where staff can be trained for community detection, streamlined referrals can be created bridging the gap between primary and secondary care, reducing hospital emergency admissions, while ensuring patients are managed optimally.

Inclusion Criteria:

- Greater or equal to 65 years old

Exclusion Criteria:

• Clinical diagnosis of Alzheimer's Disease or Vascular Dementia
• Palliative Care patients.

Patients who are ≥65yrs old who are attending their GP practice for an appointment will be studied. All patients with pre-existing diagnoses of valvular heart disease or Left Ventricular Dysfunction will also be included.