Heart failure services are continuing to improve, according to the latest National Heart Failure Audit, published by NICOR on November 27, but more action is needed to address ‘unacceptable’ regional variation.
Professor Iain Squire, co-chair of the Alliance for Heart Failure, said:
“The report once again highlights the vital nature of specialist support for heart failure patients. Those admitted under the direct care of specialist cardiology teams are more likely to receive assessment by echocardiogram and be prescribed key disease-modifying medicines for example.
“Specialist input makes a clear difference to patient survival, so it is encouraging to see that the number of patients seen by heart failure specialists has increased to over eight out of ten. Heart failure nurses are also playing a more important role on general medical wards, which is a further positive sign of improvement.
“However, the report’s authors point towards the continued variation in heart failure services between hospitals. This variation is unacceptable and must be addressed urgently. Hospitals should review their pathways, considering the ten recommendations set out in the report by the All Party Parliamentary Group on Heart Disease ‘Living with Heart Failure’ to ensure they are following best practice.”
NICOR Heart Failure Audit key findings
- During hospital admission, more than 89% of patients get an echocardiogram. However, rates are higher for those admitted to Cardiology (96%) rather than General Medical (84%) wards.
- The prescription of key disease-modifying medicines for patients with heart failure and a reduced left ventricular ejection fraction (HFrEF) remains high, including beta-blockers (87%) and mineralocorticoid antagonists (53%).
- Prescription rates for all three key disease modifying medications for patients with HFrEF has increased further from 50% to 55% for those admitted to Cardiology wards over the last year.
- The number of patients seen by HF specialists has increased to over 80% this year. HF nurses saw more HF patients admitted onto general medical wards (36%) than last year (24%).
- The mortality of patients hospitalised with heart failure remains high overall at 9.4%. However, with many more patient episodes being recorded in the audit and a trend towards increasing age, an increase in mortality would be expected. This has not happened.