National Cardiac Audit Programme

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The National Cardiac Audit Programme (NCAP) comprises of ten 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.

This year’s report focuses on the impact on cardiovascular care as services start to recover from the COVID-19 pandemic. NCAP Annual Report 2023: Time is of the essence: delays and waits need urgent action. 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 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.

NCAP Aggregate Report 2023

Report at a glance

The report covers the 12 months from 1 April 2021 to 31 March 2022 and 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.

Recovery on admissions and procedures

  • A 16% increase in the number (85,650) of confirmed high risk (STEMI) and low risk (NSTEMI) heart attacks.

  • 12% rise in the number of all procedures for children and adults with congenital heart disease, but still 8% fewer than prior to the pandemic

  • The total number of percutaneous coronary intervention (PCI) procedures in the UK has risen to 97,765, an increase from 2020/21, but not back to pre-pandemic levels.

  • Transcatheter aortic valve procedures were up 25% compared with 2019/20, compensating for 24% fewer isolated surgical aortic valve replacements.

  • Recovery is slow for the number of adult cardiac operations.16% fewer were carried out compared to 2019/20, but an improvement from 2020/21 when a 34% drop was seen.

  • Around 50% of conditions which need an operation within the first year of life were diagnosed antenatally and figures remain stable.

  • Validated admissions for heart failure rose 3% (to 63,644) compared to 2020/21 but still 8% fewer than pre-pandemic levels.

  • Overall survival rate for the 3,282 surgical operations undertaken in children under 16 years of age was 98.4% and remains among the best reported anywhere in the world.

  • Fewer than 50% of patients with heart failure were admitted to cardiology wards and people aged over 75 and women had less access to cardiology wards compared to people aged under 74 and men.

  • Emergency operations on the thoracic aorta increased to 644 cases, a 68% increase since 2013/14.

A 16% increase in the number (85,650) of confirmed high risk (STEMI) and low risk (NSTEMI) heart attacks.
12% rise in the number of all procedures for children and adults with congenital heart disease, but still 8% fewer than prior to the pandemic
The total number of percutaneous coronary intervention (PCI) procedures in the UK has risen to 97,765, an increase from 2020/21, but not back to pre-pandemic levels.
Transcatheter aortic valve procedures were up 25% compared with 2019/20, compensating for 24% fewer isolated surgical aortic valve replacements.
Recovery is slow for the number of adult cardiac operations.16% fewer were carried out compared to 2019/20, but an improvement from 2020/21 when a 34% drop was seen.
Around 50% of conditions which need an operation within the first year of life were diagnosed antenatally and figures remain stable.
Validated admissions for heart failure rose 3% (to 63,644) compared to 2020/21 but still 8% fewer than pre-pandemic levels.
Overall survival rate for the 3,282 surgical operations undertaken in children under 16 years of age was 98.4% and remains among the best reported anywhere in the world.
Fewer than 50% of patients with heart failure were admitted to cardiology wards and people aged over 75 and women had less access to cardiology wards compared to people aged under 74 and men.
Emergency operations on the thoracic aorta increased to 644 cases, a 68% increase since 2013/14.

Recovery on clinical pathways

  • Average waiting time for elective cardiac surgery in England was 114 days, 109 days in Wales and 199 days in Northern Ireland. An improvement compared to 2020/21, but not back to pre-pandemic waits of 102 days in England.

  • Only 55% of patients undergoing PCI for NSTEMI are treated within 72 hours, and 67% within 96 hours of arrival in hospital. 78% of hospitals fail to achieve the national 72-hour standard for timeliness of treatment for these patients.

  • Waiting times for urgent coronary artery bypass graft (CABG) procedures were worse, a rise to 12 days in England and 27 days in Northern Ireland, the national target is 7 days.

  • Increased use of secondary prevention medication for patients with heart failure but still only 56% received all three disease modifying drugs.

  • The number of implanted pacemakers and other electronic devices improved by 11%, but overall activity remains 7.7% less than prior to the pandemic.

  • Just under 10% of patients with heart failure were referred for cardiac rehabilitation during hospitalisation.

  • The average Call-To-Balloon (CTB) time for patients with a high-risk heart attack has increased to 142 minutes. A quarter of patients now wait more than three hours or more for treatment.

  • More than 85% of all heart attack patients who were discharged home were referred to a cardiac rehabilitation programme, continuing an upward trend.

  • In-hospital mortality for patients with a heart attack (without cardiogenic shock) undergoing primary PCI was higher at 3.3% compared to 2.6% in 2015.

Average waiting time for elective cardiac surgery in England was 114 days, 109 days in Wales and 199 days in Northern Ireland. An improvement compared to 2020/21, but not back to pre-pandemic waits of 102 days in England.
Only 55% of patients undergoing PCI for NSTEMI are treated within 72 hours, and 67% within 96 hours of arrival in hospital. 78% of hospitals fail to achieve the national 72-hour standard for timeliness of treatment for these patients.
Waiting times for urgent coronary artery bypass graft (CABG) procedures were worse, a rise to 12 days in England and 27 days in Northern Ireland, the national target is 7 days.
Increased use of secondary prevention medication for patients with heart failure but still only 56% received all three disease modifying drugs.
The number of implanted pacemakers and other electronic devices improved by 11%, but overall activity remains 7.7% less than prior to the pandemic.
Just under 10% of patients with heart failure were referred for cardiac rehabilitation during hospitalisation.
The average Call-To-Balloon (CTB) time for patients with a high-risk heart attack has increased to 142 minutes. A quarter of patients now wait more than three hours or more for treatment.
More than 85% of all heart attack patients who were discharged home were referred to a cardiac rehabilitation programme, continuing an upward trend.
In-hospital mortality for patients with a heart attack (without cardiogenic shock) undergoing primary PCI was higher at 3.3% compared to 2.6% in 2015.

NCAP

NATIONAL CARDIAC AUDIT PROGRAMME

The National Cardiac Audit Programme (NCAP) report covers quality of care and outcome measures across ten cardiovascular domains.

Each of these sub-specialty audits is concerned with a particular cardiovascular disease (CVD) of treatment:

NCAP

NATIONAL CARDIAC AUDIT PROGRAMME

The National Cardiac Audit Programme (NCAP) report covers quality of care and outcome measures across ten cardiovascular domains.

Each of these sub-specialty audits is concerned with a particular cardiovascular disease (CVD) of treatment: