NICOR publishes 2024 Annual Report with new interactive reporting

The after-effects of the COVID-19 pandemic and variations in how services are run mean not everyone has access to the same high-quality cardiac care.

NICOR has today (10 April 2024) published its National Cardiac Audit Programme (NCAP) 2024 Annual Report supported with 8 interactive sub-specialty clinical reports, and a dedicated Annual Report for Patients, Carers and the Public, covering the 12 months from 1 April 2022 to 31 March 2023.

This year’s report explores potentially important post-pandemic shifts in the demand for cardiovascular services, how these are provided, and the variability experienced in different locations.

Four years on since the World Health Organisation (WHO) declared a pandemic of coronavirus disease (COVID-19) and the UK Government instituting a first ‘lockdown’, the impacts on healthcare continue to be seen with challenges in restoring service capacity and delays to treatment. Other challenges have added to the effects of the pandemic, including difficulties in staff retention and recruitment, the onset of industrial action and the cost-of-living crisis. These all compound the burden on an already pressured NHS facing increasing demands from an expanding and ageing population.

Levels of activity for most cardiovascular sub-specialties have continued to improve and are higher than the levels seen in 2020/21 during the COVID-19 pandemic. Some areas remain below pre-COVID levels, most notably adult and paediatric cardiac surgery.

Key points from the report:

• 1 in 10 people with higher risk heart attacks are ‘self-presenting’ to hospital rather than travelling by ambulance, potentially delaying life-saving medical treatment
• The median Call-To-Balloon time for higher risk heart attack patients undergoing primary angioplasty has worsened by 28% since 2013/14
• The average waiting time for elective coronary artery bypass graft (CABG) surgery in England, Wales and Northern Ireland is 119 days, the target is under 84 days
• Alternatives to surgery are growing for valve disease cases. There has been a 36% growth in transcatheter aortic valve implantation (TAVI) procedures since 2019/20
• Surgical procedures for congenital heart disease have fallen 23% over 10 years, with interventional procedures rising by 9%
• 63% of acute coronary syndrome patients (with sudden, reduced blood flow to the heart) were not prescribed either prasugrel or ticagrelor, contrary to medication guidelines
• 82% of patients with heart failure were seen by a specialist heart failure team, but only 15% of patients cared for on a cardiology ward were referred for cardiac rehabilitation
• There has been a 17% increase in the use of implantable loop recorders for diagnostic and monitoring purposes since 2017/18.

In what remains a turbulent time for the NHS, areas of excellent practice are seen, with improved quality of care across many areas of clinical practice. This is not universal however, and the report sheds light on the variability experienced by patients in different parts of the country and individual hospitals. This remains the case especially for patients suffering a heart attack and those in need of either urgent or elective cardiac bypass surgery. Additional variances are also experienced depending on a patient’s age and sex.

In addition to the annual report, we are presenting for the first time our interactive reports for the 8 sub-specialties covered by the audit programme. They are produced with more detailed domain-level analyses and commentary. This allows clinicians, patients and members of the public, commissioners, and others to focus on the information that is of most interest to them (for example drilling down to explore the performance of different parts of the country and individual hospitals). These reports can be found on the NICOR website.

We would welcome your comments, feedback, queries, or ideas for our future reports at nicor.auditenquiries@nhs.net 

Note to stakeholders and media:

Maintaining clinical care for patients is always a top priority of the cardiovascular community. Alongside this, great efforts have been made during the pandemic to maintain a flow of audit data to NICOR’s National Cardiac Audit Programme.

The NCAP analyses combined with inputs from our clinical colleagues, patients, and carers, have allowed us to summarise experiences during that time as well as highlighting lessons to be learned for service recovery and quality improvement.

Understanding the continued pressures on hospitals and their clinical teams, a big thank you to all our colleagues and stakeholders for their continued support and contribution. Particularly our clinical colleagues, their supporting audit and clerical teams, and their hospital management teams for ensuring that important data are collected and sent to NICOR. We hope our annual reports put these data into context. In addition to the annual reports, we are incredibly pleased to see an increasing uptake in the use of our new data reporting tools across the country. These allow clinical teams to determine how they are performing on a continuous basis and provide a feedback system to help audit teams improve data quality.

National Institute of Cardiovascular Outcomes Research (NICOR)

NICOR is a partnership of clinicians, IT experts, statisticians, academics and managers who, together, are responsible for the National Cardiac Audit Programme (NCAP) including a number of new health technology registries, such as the UK TAVI registry. Hosted by NHS Arden and Greater East Midlands CSU, NICOR collects, analyses and interprets vital cardiovascular data into relevant and meaningful information to promote sustainable improvements in patient well-being, safety and outcomes. It is commissioned by NHS England and GIG Cymru /NHS Wales. Visit NICOR’s website for more information.

For any media enquiries, contact Senior Communications and Engagement Manager Sarah Colston via email sarah.colston@nhs.net.