Heart Failure Audit 2012 / 2013 

The National Heart Failure Audit report for 2012/13 was released today. You can find the report and the press release here. You can find out who are the compilers and contributors in the last paragraph.

In addition, please find a summary of the key findings of the report below. Whilst it is positive that mortality rates have fallen, it is noted that there is significant variation in prevalence rates and outcomes across the country, which requires attention.

  • National Heart Failure Audit 2012/13 key findings:
  • Audited mortality rates for patients with acute heart failure – both in hospital and following discharge – fell for the first time.
  • For patients admitted with acute heart failure in-hospital mortality rates dropped from 11.1% to 9.4%: a 15.3% relative         reduction.
  • For patients who survived to discharge there was also an improvement in outcomes: 24.6% of patients discharged in 2012/13 died during the year, compared to 26.2% last year.
  • The report shows that there is wide variation in care depending on ward of treatment, and also between hospitals. This year’s audit, which collected data on 43,894 heart failure admissions between 1 April 2012 and 31 March 2013, supports findings from previous years, highlighting the urgent need for more patients who are admitted to hospital with heart failure to receive specialist care, preferably on a cardiology ward.
  • If a patient is treated on a cardiology ward the likelihood of survival to discharge is far greater than if a patient is admitted to other wards – in 2012/13 only 7.0% died if admitted to a cardiology ward compared to 11.3% on general medical wards and 14.4% on other wards.
  • When analyses were adjusted for age and severity of disease, the added benefit of being treated on a cardiology ward remained. Patients not treated on a cardiology ward are 54% more likely to die in hospital than their cardiology counterparts. For all patients who survived to discharge in 2012/13, those not treated on a cardiology ward were 14% more likely to die within the audit year, when confounding factors are taken into account.
  • Only half of all patients included in the 2012/13 audit were treated on cardiology wards, although 78% were seen by a nurse or doctor with a heart failure specialism.

Professor Huon Gray, National Clinical Director for Heart Disease at NHS England said: “More patients are being cared for within specialist cardiac care or cardiology wards, more patients are receiving specialist input overall, and improved prescribing rates of disease modifying drugs are seen. This is encouraging but there remains much that can be done to ensure all patients receive an early diagnosis and care from a specialist cardiology team. When patients leave hospital they can be especially vulnerable and early careful review from within the multidisciplinary team will help drive better outcomes.”

About the National Heart Failure Audit

The National Heart Failure Audit was established in 2007 to monitor the care and treatment of patients in England and Wales with acute heart failure. The audit reports on all patients discharged from hospital with a primary diagnosis of heart failure, publishing analysis on patient outcomes and clinical practice. Audit findings can be used to measure the implementation of contemporary guidelines for the clinical management of heart failure from the National Institute for Health and Clinical Excellence (NICE) and the European Society of Cardiology Heart Failure Association (ESC HFA).

The audit has consistently shown that specialist cardiology input and the prescription of recommended treatments are associated with prolonged survival and better outcomes for heart failure patients. Audit data is used by a number of national groups, including the NHS Information Centre, the Care Quality Commission and, as of 2012, audit analysis will be published on data.gov.uk.

The British Society for Heart Failure provides clinical input and strategic direction to the National Heart Failure Audit. The audit is managed by the National Institute of Cardiovascular Outcomes Research (NICOR), part of the National Centre for Cardiovascular Preventions and Outcomes (NCCPO) at University College London. It is commissioned by the Healthcare Quality Improvement Partnership (HQIP).

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