The latest NICOR report for the 2022/23 data came out in April. Ahead of the next parliament, we have pulled out the most pertinent points of data in relation to our present and future work.
In some instances, we have given our inferences about what this data shows, and how we can use it might inform our campaigns and strategy moving forwards.
Firstly, the topline findings in terms of cases admitted to hospital were the following:
- In 2022/23 there were 63,530 confirmed hospital admissions for heart failure, down 8.6% since 2019-20
- The report noted that the rise in the number of patients admitted to hospital with heart failure (HF) since 2014/15 appears to be ‘flattening out’. The 63,530 HF admissions for 2022/23 were very similar in number to the previous year.
The extent to which this confirms the burden of heart failure is being relieved is unclear. Given the NHS Long Term Plan stated that 80% of heart failure cases in England are diagnosed in hospital (despite 40% of patients having symptoms that could have triggered diagnosis in primary care), data is needed to clarify the extent to which more patients are being diagnosed and treated outside the hospital setting.
Alongside this, there is a threefold difference in the rate of HF admissions across Integrated Care Boards. Some of this reflects deeply ingrained local, rather than regional variation. For example:
- In Bath and North East Somerset, Swindon and Wiltshire the rate is 40 per 100,000 while in Devon ICB it is 146 per 100,000
- Cardiac Networks also vary, from 53 per 100,000 in South London to 148 per 100,000 in South Yorkshire
Cardiology wards
The report also highlights an issue with the number of patients being treated on a cardiology ward – 40% – well below the audit’s target of 60%.
In fact, only 15% of hospitals achieved the target of 60% of patients being admitted to a cardiology ward.
This is concerning as echocardiography rates are inadequate and worsening for patients not cared for on cardiology wards, and especially for those who do not receive HF specialist input (only 65%).
One year survival is also significantly better for those treated on cardiology wards.
Cardiac rehabilitation
Referral to cardiac rehabilitation for patients discharged from both cardiology wards and general wards remains under 20%, suggesting little recovery from the pandemic.
This is especially concerning given the report highlights that one year survival rates are significantly better for those who receive access to these services:
NICOR has subsequently focused its recommendations on patient access to cardiology wards, in-patient echocardiography and cardiac rehabilitation. The Alliance plans to work this data and NICOR’s renewed focus into its campaigns improving access and use of an NT-proBNP blood test, implementing the recommendations of the British Society for Echocardiography’s workforce report and improving the diagnosis and treatment of heart failure through community pharmacies.
You can read more about these campaigns here.