Report out today highlights progress in cardiovascular care and makes recommendations for improvement
The National Cardiac Audit Programme’s annual report details key information about the safety and clinical effectiveness of cardiovascular services, and also patient outcomes in England and Wales. The report from the National Institute for Cardiovascular Outcomes Research (NICOR) recognises areas of clinical excellence that can be adopted across the NHS, identifies areas where care falls below expected standards and makes 16 important recommendations to improve patient outcomes.
Professor John Deanfield, Director of NICOR, explains: “This report is the first National Cardiac Audit Programme report, bringing together the 6 major national cardiovascular audits for the first time in a single report. The programme has analysed data from over 300,000 patients. This report has been supported by UCL Partners and includes the results of five of these audits, covering the fields of Congenital Heart Disease, Heart Attack, Angioplasty, Adult Surgery and Heart Failure. The results of the Cardiac Rhythm Management audit will be presented later in a separate report. Hospitals are provided with their own data for each metric and can see how they compare with others. These results help determine national quality improvement aims for clinicians, service managers and commissioners.”
The full analyses, including hospital level data for all the sub audits, and a summary of the key messages and recommendations, can be accessed via NICOR’s website https://www.nicor.org.uk/national-cardiac-audit-programme/ from today, Thursday 22 November.
Data published today by the National Congenital Heart Disease Audit (NCHDA) shows that survival 30 days after paediatric cardiac surgery for children with congenital heart disease has continued to improve for children in recent years and is currently close to 98%. After consideration of case complexity, survival 30 days after heart surgery for children was either at the expected level or better than predicted in each of the paediatric centres providing care.
Dr. Rodney Franklin, NICOR’s Clinical Lead for the NCHDA said:
“Overall survival after congenital heart procedures in UK and Republic of Ireland remains good and as high as reported anywhere in the world.”
The report also highlights that antenatal ultrasound scan detection rates of congenital heart conditions have improved year on year between 2003 and 2016 from 36.1% to 50.4%, however there is continued room for improvement by targeting sonographer training to regions performing less well.
Dr. Rodney Franklin said: “Antenatal detection is very important because advance warning that a child has a congenital heart problem leads to better planned care after birth, often with improved survival and fewer complications following treatment. The audit is working closely with Public Health England to improve detection in this area.”
The NCHDA collected data following 33,754 congenital heart surgical operations and transcatheter interventional procedures performed in 34 hospitals, including all 14 specialist paediatric units, between 2013 and 2016 in the UK and the Republic of Ireland (RoI). Other key findings from the report include:
During 2015-16, the most recent year, 10,887 therapeutic procedures were carried out, of which 7,695 were on children and 3,192 were on adults; the number of therapeutic cardiac procedures undertaken annually has risen by over 40% between 2003 and 2016, and furthermore additional novel interventions have been introduced, the outcomes of which are reported here for the first time.
Risk adjusted full programme 30-day postsurgical survival at all 14 centres undertaking cardiovascular procedures in children and young people below 16 years of age was within acceptable predicted control limits, with a trend of continuing year on year improvement.
Survival at 30 days after all 72 major surgical and cardiovascular interventions undertaken to treat congenital heart disease at any age was good in all centres, with a single procedural exception at two centres.
The NCHDA, now in its 17th year, is managed by the National Institute for Cardiovascular Outcomes Research (NICOR) and is the largest and most comprehensive national audit of its kind in the world. The audit collects data from all centres undertaking congenital cardiac surgery and interventional procedures in the UK (since 2000) and RoI (since 2012).
NCHDA is commissioned by the Healthcare Quality Improvement Partnership as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) and clinically led by the British Congenital Cardiac Association and The Society for Cardiothoracic Surgery in Great Britain and Ireland.
The full analyses can be accessed via the National Congenital Heart Disease Audit portal
The National Congenital Heart Disease Audit (NCHDA) has today published the 2010/13 annual analysis. The analysis covers 22,979 congenital heart operations and transcatheter interventional procedures undertaken across 34 UK centres, including all 14 specialist paediatric units, between 2010 and 2013. Key findings include:
- Survival at 30-days after each of the 56 surgical and transcatheter cardiovascular interventions most frequently undertaken to treat congenital heart disease in children, young people and adults continues to be within the appropriate limits and not below the red alert limit.
- For the 56 specific procedures used as a basis of inter‐unit comparison, there was one warning level outliers for paediatric cardiac surgery at a single centre and none for paediatric intervention, adult congenital heart disease (ACHD) surgery and ACHD intervention. The hospital concerned has been contacted by NICOR and the relevant professional societies, and the centre’s response is available on the NCHDA portal.
- Analysis of the 30 day post procedural outcomes for all hospitals shows an upward trend in survival in the most recent 18 months. The overall 30 day survival for all congenital heart disease procedures is extremely high and indeed one of the highest reported anywhere in the world.
- Antenatal diagnosis of congenital heart disease has gradually improved over the past 8 years. In 2013/14, approaching 45% of infants who required a procedure to treat a congenital heart malformation in the first year of life were diagnosed through antenatal screening, compared to less than a quarter of cases in 2003/4.