This report is designed to be useful to a wide audience of stakeholders, including patients, clinicians, management teams and commissioners of healthcare, who are interested in cardiovascular conditions and their treatments.
The overall aggregate report highlights aspects of safety, clinical effectiveness and patient outcomes. The audit findings recognise areas of clinical excellence that can be adopted across the NHS, but also identify areas where care falls below expected standards. These standards should be used to determine local and national quality improvement aims for clinicians, service managers and commissioners.
A summary of the six sub-specialty audits that have been brought together as a single National Cardiac Audit Programme (NCAP) is provided in the Executive Summary, together with the key recommendations from this year’s analyses. Click here to go directly to the Executive Summary. Below are links to landing pages for all six sub audits. Data by hospital is available for each of these sub audits and can be found on the respective pages.
The treatment of heart conditions continues to evolve and this report describes a number of key developments to enable an understanding of what constitutes high quality care.
The key aim of service improvement is to deliver better outcomes for patients, both in terms of their chances of survival and the experience they have while being cared for, and the report presents findings on how these are changing. With improved survival rates, emphasis is shifting to other measures that are important to patients and which can be used to audit change over time.
The findings in this aggregate report are presented at a national level. This should allow stakeholders to understand both where advances have been made to deliver quality improvement and remaining challenges. In reading this document it will be clear that many of the issues are common to the different types of heart disease and management. However, there is important information specific to individual cardiac conditions that are also of great interest. This report will enable an interested person to work from the improvement questions to the specific area of interest in a seamless and efficient way. More detailed information of the performance of a particular hospital (or to compare hospitals) is provided using links to the full ‘granular’ data analyses for each audit throughout the report. For the vast majority of hospitals, the results are reassuring and patients, providers and commissioners can have confidence in the quality of their local services. For some hospitals, however, there are elements of service delivery that could be improved and the audit data can point to where improvements can be made.
Two of the audits (Angioplasty and Adult Surgery) provide data on the performance of individual ‘operators’ (i.e. the surgeons or cardiologists undertaking the procedure). This is part of the Clinical Outcomes Publication (COP) programme run by the Healthcare Quality Improvement Partnership (HQIP) and made available through the NHS Choices website. While individual performance is dependent on a number of external factors, including ‘case mix’ and institutional/team characteristics, these data are of great interest to patients and the public and the results can form part of the annual appraisal that all practising medical professionals undertake.
Some of the cardiovascular services covered are funded by regional commissioners but many are highly specialised and are commissioned nationally. This report and the supporting hospital-level data provide a means of establishing how providers are performing and will aid local, regional and national discussions on service delivery.
A summary of the cardiovascular diseases and related treatments are included in Appendix A.
The organisation of the national audits and the methodology used in producing results are explained in Appendix B.
This report covers five of the six audits in NCAP. A further version of the report will be issued later in the year to include, additionally, the findings and quality improvement suggestions from the Arrhythmia audit (as the validation and analysis for this is ongoing).
