Time is of the essence: delays and waits need urgent action for cardiovascular care

NICOR has published today (8 June 2023) its National Cardiac Audit Programme (NCAP) Annual Report 2023.

The report, called “Time is of the essence: delays and waits need urgent action” covers the 12 months from 1 April 2021 to 31 March 2022, during the second year of the COVID-19 pandemic and records the initial recovery of NHS hospital services for patients with cardiovascular disease.

The NHS continues to face huge challenges two years after the onset of the first wave of the COVID-19 pandemic. Across many NHS services patients are experiencing delays and waits to access treatment, which are potentially having a detrimental effects on patients, staff and the families and/or carers of patients.

Key points from the report:

• The number of patients presenting to hospital and the number of treatments delivered were nearly back to pre-pandemic levels in the majority of sub-specialties
• The number of congenital heart procedures overall had partially recovered but were still 8% fewer than pre-pandemic levels; recovery was mainly for percutaneous interventional and pacing procedures but cardiac surgical procedures in children had not recovered
• 19% of heart attack patients self-presented to hospital rather than waiting for an ambulance
• The times to emergency treatment of patients with high risk heart attacks worsened and there were significant delays to urgent treatment for patients with lower risk heart attacks
• Waiting times for urgent coronary artery bypass graft (CABG) procedures were worse, with no hospital achieving the 7-day target
• Fewer than half of patients were admitted to cardiology wards and gender and age inequalities were seen
• Just under 10% of patients admitted with heart failure in 2021/22 were referred during hospitalisation for cardiac rehabilitation
• 30-day mortality has improved for heart failure patients
• Use of leadless pacemakers increased significantly.

The Annual Report is accompanied by supporting reports from six sub-specialties covered by the audit programme and a dedicated Annual Report for Patients, Carers and the Public, which was co-written by the NICOR Patient Representative Group Chair, Sarah Murray, and patient representative Richard Corder and includes patient experiences during the recovery period.

Sarah Murray, Chair of NICOR’s patient reference group said: “Post pandemic there was focus on getting services back up and running to an acceptable level. Last year’s report reflected that during this time there was innovation and clever ways of working to help the very sick receive care despite the pandemic waves.

“This report highlights the wake of the disruption. The most startling but unsurprising outcomes were the stories of appointment and operation cancellations – often multiple times – and the affect these setbacks have had on patients’ physical health and wellbeing as well as their financial health and inability to get back to work. Carers also take the strain, supporting families as well as the sick. It is, quite literally heart-breaking.

“In the midst of all this there are glimmers of hope that show some services are back on track and new ways of working and innovation are being deployed. These may help the services regain some ground and positive stories of wonderful care from the NHS have emerged. But this is not enough.

“We have a backlog of sick and dying patients who need care, and they need it now not next year or in a few months’ time. The challenge is massive, it could be you; it could be me – we are all potential patients, and we need to do all we can to highlight the issues and hold the NHS to account.

“This report makes for sober reading and the challenges are laid bare – let’s meet them.”

John Deanfield CBE, NICOR Director said: “As we continue to recover from the COVID-19 pandemic, this report highlights the important message on the need to urgently address the delays and wait times currently being seen across the delivery of cardiovascular care.

“It is hoped this report will prove very helpful and will help inform local NHS organisations and national policy priorities required for cardiovascular patients, carers and NHS staff.”

We would welcome your comments, feedback, queries, or ideas for our future reports at nicor.auditenquiries@nhs.net