National Cardiac Audit Programme

The National Cardiac Audit Programme (NCAP) comprises 11 specialty domains, each of which is focuses on a particular cardiovascular disease area or treatment. The aim is to deliver better outcomes for patients, both in terms of their chances of survival and the experience they have while being cared for. Each domain provides a background to the national picture and presents findings on how these are changing.
NCAP Annual Report 2023: Time is of the essence: delays and waits need urgent action.
This year’s report focuses on the impact on cardiovascular care as services start to recover from the COVID-19 pandemic. The main focus is on the time delays and waits for treatments. As we have learnt to accept and understand COVID-19, assisted by vaccine-induced and natural immunity, the healthcare services are also in recovery, aiming to reach pre-pandemic levels of activity and meet national targets.
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. Patients are experiencing delays and waits to access treatment, which is potentially having a detrimental effect on patients, staff and the families and/or carers of patients.
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.
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.”
For more information about NCAP and the 11 domains, visit the About Us section.
National Cardiac Audit Programme Sub-Speciality Audits
Learn about progress in diagnosis and treatment
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.
See how improvements in services are changing outcomes for patients
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.
Find out the results for particular hospitals and clinicians
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). 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.
Become more familiar with the nature of the conditions
A summary of the cardiovascular diseases and related treatments are included in Appendix A of the NCAP 2018 Annual Report.
Understand how audit data comes together and how the analysis works
The organisation of the national audits and the methodology used in producing results are explained in Appendix B of the NCAP 2018 Annual Report.
Earlier Reports
National Cardiac Audit Programme (NCAP) Report 2022 (2020/21 data)
NCAP Annual Report 2022: The Heart in Lockdown
The NHS faced huge challenges during this time. Across cardiovascular services, bed capacity and staff were redeployed to support COVID-19 patients. Out-patient services were seriously disrupted. There were high levels of illness across the workforce. Staff had to take special measures to protect patients as well as themselves.
Maintaining clinical care for patients has been the top priority of the cardiovascular community. Alongside this, great efforts were made to maintain a flow of audit data to the NCAP programme delivered by the National Institute for Cardiovascular Outcomes Research (NICOR). This has enabled the analytical work needed to track the impact of the pandemic on cardiovascular services and patients.
This report summarises key findings from the National Cardiac Audit Programme (NCAP) based on data collected between 1 April 2020 and 31 March 2021 (or between 2018 and 2021 for those analyses requiring three years’ consecutive data).
Annual Report for Patients, Carers and the Public 2022 (2020/21 data)
National Cardiac Audit Programme (NCAP) Report 2021 (2019/20 data)
NCAP Annual Report 2021 : The way we were
A pre-pandemic stocktake to help the recovery
This report summarises key findings from the National Cardiac Audit Programme (NCAP) based on data collected between 1st April 2019 and 31st March 2020 (or between 2017 and 2020 for those analyses requiring three years’ consecutive data). Trends in data from 2010/11 are provided where appropriate to provide a comprehensive stocktake of progress and continuing challenges from the decade prior to the pandemic. As such, it represents the state of play up to the point we were just entering the national COVID-19 pandemic (the first lockdown occurring on the 23rd March 2020).
NCAP Annual Report for Patients, Carers and the Public
The Acid Test: 2020 Report (2018/19 data)
Annual Report for Patients and the Public 2020 (2018/19 data)
Improving Cardiovascular Outcomes: 2019 Report (2017/18 data)
Last year’s 2019 aggregate report was structured around the themes of timely care, specialist care and evidence-based care delivered equitably. 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.
In 2019 we also produced our first dedicated Report for Patients and the Public.
Annual Report for Patients and the Public 2019 (2017/18 data)
Towards Healthier Hearts: 2018 Report (2016/17 data)
Click here to access the 2018 National Cardiac Audit Report and also the Executive Summary and Key Messages. There is also an infographic with some of the report’s key findings of interest to patients.
*The results of the Arrhythmia audit for 2016/17 were published on 11 July 2019
The 2018 and 2019 reports covered five of the six audits in NCAP. A further report was issued with the findings and quality improvement suggestions from the Arrhythmia audit .