NICOR, the Society for Cardiothoracic Surgery (SCTS), and the University of Manchester, has released the SCTS Governance Tool. This new online rescource enables cardiac surgery consultants to access information about their clinical activity and outcomes, which facilitates effective monitoring of data quality and clinical practice. The tool allows selection of time periods and operative groups to generate downloadable reports ‘on demand’, which show analysis based on up-to-date, and 'cleaned', National Adult Cardiac Surgery Audit (NACSA) data. More...
Published: Feb 7, 2014 3:28:12 PM
The 2012 annual report on devices from the Cardiac Rhythm Management National Audit has now been published. It is available to view and download from: More...
Published: Feb 5, 2014 1:48:26 PM
NICOR (The National Institute for Cardiovascular Outcomes Research) collects anonymised patient information from across UK hospitals to try and improve the quality of care and outcomes for patients that have heart problems and treatments. These include adult heart surgery, heart attack, heart procedures, heart devices (for example pacemakers), heart failure and congenital heart surgery. More...
Published: Feb 4, 2014 2:11:08 PM
Report National Audit of Percutaneous Coronary Interventional (PCI) procedures 2012
published January 30th 2014.
Expansion in the use of Percutaneous Coronary Intervention (PCI) is seeing more patients with acute coronary syndromes treated more quickly, according to the latest National Audit of PCI (covering 2012). Key findings from the report include: More...
Published: Jan 30, 2014 8:09:31 AM
Acute myocardial infarction: a comparison of short-term survival in national outcome registries in Sweden and the UK
The Myocardial Ischaemia National Audit Project (MINAP), from which the data for the Lancet paper was obtained, continues to collect detailed information about the care provided to patients with heart attack. This demonstrates the commitment of participating clinicians, Trusts and governments to improvements in quality of care. While important improvements have been made since 2010, the end of the period studied by the researchers, there is no room for complacency. We need to continue emphasising both the provision of the best modern care, and the recording of that care. We also need to shift from publishing details of the process of care to the outcomes of care. It is our intention to produce a preliminary report of outcomes for each hospital this year. More...
Published: Jan 23, 2014 10:33:12 AM
Heart failure is a condition in which the heart has lost the ability to pump enough blood to the body's tissues. With too little blood being delivered, the organs and other tissues do not receive enough oxygen and nutrients to function properly.
The most common causes of heart failure are:
- coronary artery disease and heart attack
- high blood pressure (hypertension)
- heart valve disease
- congenital heart disease
- excessive alcohol consumption
Why was the audit selected?
Heart failure is an extremely prevalent condition: Heart failure affects at least 1% of people the UK, increasing steeply with age to 16.4% in men over 75. The number of patients with heart failure is set to rise in the next twenty years. This is due to the combined effects of improved survival after a heart attack and an ageing population.
Heart failure has a significant impact on patients: Survival rates are worse than for breast and prostate cancer, with annual mortality ranging from 10 per cent to 50 per cent depending on severity, and a high risk of sudden death. Patients with heart failure experience a poor quality of life, with over a third experiencing severe and prolonged depressive illness.
Heart failure has a significant impact on NHS resources: Heart failure is one of the largest sources of emergency hospital admissions, readmission rates and occupied bed days, equating to almost 5 per cent of all emergency medical admissions.
The role of the audit
Progress in improving heart failure services has been slow compared to progress in other areas of heart disease, e.g. management of heart attacks and revascularisation. There is a lack of national data on heart failure services. There is also a lack of local data - one of the enduring findings of a Healthcare Commission review (2007) of heart failure services was that fewer than 20% of organisations were able to meet the CHD NSF criteria (2000) for auditing the delivery of heart failure services. This is despite a milestone of 2002 (hospitals) and 2003 (PCTs).
The National Heart Failure Audit provides aggregate data on the diagnostic tools, care, treatments and follow-up care that patients with heart failure receive, and can analyse morbidity and mortality in light of these indicators. Audit data can therefore inform guidelines for best practice and help hospitals to monitor their performance. There is good evidence that appropriate diagnosis, treatment and ongoing support can improve quality of life, help reduce morbidity and mortality and reduce hospital admission.
Annual reports are published online, and can be downloaded from the Annual Reports webpage.
Progress to date
Participation in the audit has improved substantially since 2009/10, with 85% of NHS Trusts and Welsh Health Boards now participating, and submitting data on 36504 patients: 54% of all patients discharged with heart failure as a primary diagnosis.
Key findings from the 2011 annual report (pdf) show that although access to NICE recommended diagnostic tests and key treatments is fairly good, variation in patient outcomes continue:
- Just under 12% of patients died during the hospital admission and almost one third died within 12 months of discharge.
- Outcomes for patients are strongly associated with certain key factors, including the prescription of beta blockers, ACE inhibitors and other clinically recommended drugs, and the use of follow up services in community and primary care services.
- Patients admitted to cardiology wards had in-hospital mortality rates of 8%, compared to 14% for patients admitted to general medicine and 17% for those admitted to other wards.
- Mortality rates after discharge are significantly better for those who received cardiology follow up (18% vs. 31%) and those referred to heart failure specialist nursing services (22% vs. 27%) compared to those who were not.
Despite this evidence base, access to the highest quality of care is mixed:
- The uptake of evidence-based guidance on diagnosis, treatment and therapy remains mixed.
- Under half of patients (45%) were admitted to cardiology wards.
- Only 65% were prescribed beta blockers on discharge, although this figure was significantly higher for those patients admitted to cardiology wards (78%) compared to those in in general medical wards (63%).
- Under half of patients (47%) with a confirmed diagnosis of heart failure were referred to heart failure liaison services on discharge.
Page last modified on 31 jan 12 11:02