National Heart Failure Audit (NHFA)

The National Heart Failure Audit (NHFA) collects data on patients  with an unscheduled admission to hospital in England and Wales who are discharged with a primary diagnosis of heart failure.

What is Heart Failure?

Heart failure is a complex clinical syndrome where the heart does not adequately pump blood around the body. As the heart is not able to supply enough oxygen to the body, heart failure often leads to shortness of breath and fatigue, and can also lead to fluid retention in the chest cavity, legs and ankles. It is a long term condition, which sufferers can live with for many years, and can be treated by pharmacological treatments – such as beta blockers and ACE inhibitors – or by device therapies – for example, pacemakers or defibrillators. Heart failure is caused by a variety of cardiac abnormalities, such as previous heart attacks, cardiomyopathies, hypertension and valve disease. Further inforamtion is available on the British Heart Foundation or NHS websites.

National Heart Failure Audit (NHFA)

The audit aims to drive up the quality of the diagnosis, treatment and management of heart failure. By collecting, analysing and disseminating data, and eventually to improve mortality and morbidity outcomes for heart failure patients. The audit is managed by NICOR, with clinical direction and strategy provided by the British Society of Heart Failure (BSH).  The audit is part of the National Cardiac Audit Programme in NHS England.

The audit captures data on clinical indicators which have a proven link to improved outcomes for heart failure patients, and to encourage the increased use of clinically recommended diagnostic tools, disease modifying treatments and referral pathways. The dataset is updated periodically to ensure that the data collected remains in line with contemporary clinical guidance. Hospital level data are to be found in the interactive version.

The 2026 Interim Summary NHFA report covers 1 April to 30 September 2025.

2026 Interim Summary Report Key findings:

National Heart Failure Audit (NHFA): most patients with heart failure were treated according to guidelines but not in all hospitals. Just under 90% of expected submissions were received for Q1/Q2 2025/26. The majority of patients admitted with acute heart failure were seen by a specialist team, although still only about 40% were cared for on a cardiac ward. There are still too many hospitals that do not investigate all patients according to national guidelines, but most patients have an ECG performed and undergo an echocardiogram to determine the type of heart failure.

Data quality still needs to improve to allow certainty about conformance with guidelines as regards to secondary prevention treatments, but most patients were treated with a beta blocker and an ACE-inhibitor (or similar type of drug), and an increasing number are now being prescribed a sodium glucose co-transporter 2 inhibitor (SGLT2i). Fewer than expected patients with reduced ejection fraction were prescribed a mineralocorticoid receptor antagonist (MRA).

Previous reports for National Heart Failure Audit (NHFA) are available to download via the Previous reports page.

Clinical lead: Dr Suzanna Hardman

nicor.auditenquiries@nhs.net