Category Archive: General
In conjunction with UCL Partners we are delighted to be able to link to a video of the Quality Improvement (QI) Roadshow held in Leeds on Friday 6 March 2020. Please share with any colleagues who you think would be interested!
The health and social care system is going to face significant pressures in the coming months due to the COVID-19 outbreak. Staff will need to work in different ways than usual and we want to ensure that they can focus on responding to these events.
NHSX and NHS Digital have therefore made the decision to extend the compliance deadline for the national data opt-out and the final date for submission of the Data Security and Protection Toolkit (DSPT) to 30 September 2020.
Visit our National Data Opt-out page
Visit our COVID-19 information page
Firstly, thank you for all your hard work at this difficult time. We are acutely aware of the issues the NHS is facing.
From Monday 23 March NICOR will temporarily be moving to email only support. After careful consideration, in order to protect our staff and reduce the spread of the COVID-19 virus most of our London-based team will be working remotely for the foreseeable future. We will be sending regular bulletins to keep you informed. Technical Helpdesk support, general enquiries and audit queries will all be dealt with via email by our team in the normal way. Unfortunately we will not be able to receive phone calls nor pick up any voicemail messages. We will continue to do our very best to support you and the audit teams. However, if the NICOR staff are redeployed to support the Barts clinical teams there may be a reduction in our service, but we will keep you informed.
We thank you all for your understanding.
The NICOR Team
NICOR has taken the decision to postpone next Friday’s QI Roadshow in Bristol, in partnership with UCL Partners, due to the COVID-19 coronavirus risk. A new date will be arranged and participants notified by UCL Partners via Eventbrite.
If you have any questions please email us at firstname.lastname@example.org
In this edition:
- NICOR contract extension
- Regional NICOR/UCLP QI roadshows
- Clinical Lead role for National Congenital Heart Disease Audit
- Patient Group
- IT update
- Research data update
NICOR e-Newsletter Feb 20
Do you have the passion and the skills required to lead the National Congenital Heart Disease Audit to the next phase of Quality Improvement?
We are looking for a Consultant Congenital Cardiologist or Surgeon to provide clinical leadership for the National Congenital Heart Disease Audit (NCHDA), one of the six specialist domains of the National Cardiovascular Audit Programme (NCAP), managed by the National Institute for Cardiovascular Outcomes Research (NICOR). The NCAP, funded by the Healthcare Quality Improvement Partnership (HQIP), is hosted at Barts Health NHS Trust which holds the NCAP contract. NICOR is the delivery arm of the NCAP contract.
Find out more, including job description and application details here
Very proud that our National Cardiac Audit Programme Annual Report for Patients and the Public 2019 was commended by the Healthcare Quality Improvement Partnership (HQIP) in their Richard Driscoll Memorial Award which celebrates excellence in patient and public engagement in clinical audit. Read it here
The National Cardiac Audit Programme’s 2019 annual report (2017/18 data) details key information about cardiovascular services and patient outcomes in England and Wales. The report launched today by the National Institute for Cardiovascular Outcomes Research (NICOR), the national cardiac audit provider hosted at Barts Health NHS Trust, also highlights quality improvement opportunities by recommending actions for clinicians, service managers and commissioners of healthcare services.
Nationally the report shows that there has been particular progress in areas relating to the specialist care of congenital heart disease, heart failure and heart attack patients in the last few years.
* The overall rate of antenatal detection of fetal cardiovascular abnormalities which require intervention in the first year of life has risen to over 50%, with particularly good improvements in complex conditions. The report suggests reviewing staffing levels, the availability of the necessary ultrasonography equipment and ensuring that obstetric sonography staff are receiving appropriate education and training.
* 96% of patients admitted with NSTEMI (lower-risk) heart attacks and 82% of those admitted with heart failure were seen by specialist teams in 2017/18 (all STEMI (high-risk) heart attack patients undergoing emergency treatment are necessarily managed by interventional cardiologists on admission to hospital). Hospitals are recommended to ensure that all such patients have equal access to specialist care, either by admitting more patients to a cardiology ward or by using specialised nursing cardiac ‘outreach’ teams to support patients on other types of wards.
The report paints a more challenging picture of timeliness of care, with large variations between hospitals for time to treatment of heart attacks with angioplasty (PCI) and coronary artery bypass graft surgery, as well as diagnosis of non-emergency heart attack cases by angiography.
* The median ‘call-to-balloon’ time to treatment of heart attacks with emergency percutaneous coronary intervention (primary PCI) has increased by 9 minutes over the last 3 years. There are also sizeable variations between hospitals in the proportion of patients that undergo treatment within 60 minutes of admission. There are Quality Improvement actions for hospitals, ambulance services and STPs/local health systems to address this, particularly around the logistics of admitting patients. Patients themselves can assist by calling for an ambulance rather than attempting to get themselves to hospital.
* Times to coronary artery bypass graft (CABG) surgery have not improved significantly at a national level. Just over a third of patients have the procedure within 7 days of the diagnostic angiogram. Hospitals are advised to ensure that at least 75% of patients requiring urgent CABG receive this treatment within 7 days of the angiogram which, in most circumstances, implies the patients should undergo the procedure as an in-patient.
Geographical variation is also apparent when considering whether evidence-based treatment (such as that supported by national and international guidelines) is delivered equitably to patients. This is marked in the case of heart failure patients being discharged on the recommended package of three medicines. The situation is more encouraging in the case of percutaneous coronary interventions. Advances in practice such as radial access and the use of modern drug-eluting stents have meant that treatment is safer and more effective. There has been a rise in elective PCI performed as a day-case.
* Well over half of hospitals are not achieving the target of offering the triple package of heart failure medicines to at least 60% of patients. These hospitals should especially look to increase the use of mineralocorticoid receptor antagonist (MRA) drugs.
* Use of day-case angioplasty is growing. There is, though, extremely wide variation between hospitals, with some centres performing day-case angioplasty in almost all elective cases, and some where almost all patients are kept in overnight following their procedure. Hospitals should aim to offer day-case angioplasty to at least 75% of their elective cases.
Professor John Deanfield, Director of NICOR, said:
This report builds on last year’s first National Cardiac Audit Programme report, which brought together 5 major national cardiovascular audits for the first time in a single report. The programme has analysed data from over 300,000 patients. This 2019 annual report, supported by UCL Partners, covers the fields of Congenital Heart Disease, Heart Attack, Percutaneous Coronary Interventions (PCI), Adult Surgery and Heart Failure. The results of the National Cardiac Rhythm Management audit for 2017/18 will be brought into next year’s 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.
Access the full analyses here
Read our end of year newsletter and learn about some of NICOR’s important work and achievements in 2018, such as the launch of our new website, the publication of our report and our work with ambulance data.
Newsletter Dec 18
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.