Groundbreaking findings from the largest ever heart failure audit in England and Wales reveal a big difference in mortality rates between those who receive specialist cardiology services when they are admitted to hospital and those who do not.

The third report from the National Heart Failure Audit, which analysed more than 21,000 patient records, suggests about 32 per cent of heart failure patients will die within a year of their hospital admission.

However the mortality rate falls to 23 per cent for those are seen by a cardiologist or have access to specialist heart failure services.

In-patient mortality is also twice as likely for a heart failure patient if they are on a non cardiac ward; at 12 per cent compared to 6 per cent.

Today's audit report presents the most robust findings to date about patient mortality for heart failure – which affects about one in every hundred people in the UK and rises to one in 15 for those aged 75 and over.

Run jointly by The NHS Information Centre and the British Society for Heart Failure and commissioned by the Healthcare Quality Improvement Partnership (HQIP), the report focuses on the care of patients with unscheduled admissions to hospital for heart failure in England and Wales between April 2009 and March 2010.

NHS trusts in England and local health boards (LHBs) in Wales submitted admission data on 21,294 patients - a 400 per cent increase on the previous year. This represents about 40 per cent of heart failure patients and the audit recommends that trusts and LHBs build on their positive progress and submit more data for future reports.

The audit also suggests many patients are prescribed less than 50 per cent of the target dose for drugs like ACE Inhibitors - which when used effectively can halve mortality in the year after discharge - or beta blockers, which can reduce mortality by around a third.

• Of the 17,520 patients with recorded data about the use of beta blockers, 60 per cent were prescribed them. However the level of dosage was often not recorded and for the 5,210 patients with a dosage record – two thirds received less than 50 per cent of the target dose.
• Of the 5,930 patients with a record of ACE Inhibitors; half received less than 50 per cent of the target dose.

The report also shows that people from poorer areas are admitted to hospital around five years earlier in life for heart failure than people in the most affluent areas.

Dr Theresa McDonagh, Chair of the British Society for Heart Failure and audit clinical lead said: “This audit shows that patients admitted to hospital with heart failure have an unacceptably high death rate.

“Outcomes for these patients can be significantly improved by having specialist cardiology input to their care, administration of appropriate evidence-based doses of key drugs and follow-up by specialist services.”

Heart failure is also one of the top 10 conditions for taking up the biggest amount of bed days in England – numbering 740,700 in 2009/10 - despite the number of admissions for the condition – 53,160 - being outside of the top 10. It costs the NHS an estimated £625million a year.

The number of heart failure patients is set to rise in the next 20 years due to an aging population and improved survival rates following heart attacks. Patients often have a poor quality of life, with over a third experiencing long and depressive illness.

Today's report can be accessed at: services/national-clinical-audit-support-programme-ncasp/audit-reports/heart-disease.

Embargoed copies are available from The NHS IC press office.

ENDS

Notes to editors

1. The NHS Information Centre for health and social care (The NHS IC) is England's authoritative, central, independent source of health and social care information. It works with a wide range of health and social care providers nationwide to provide the facts and figures that help the NHS and social services run effectively. Its role is to collect data, analyse it and convert it into useful information which helps providers improve their services and supports academics, researcher, regulators and policymakers in their work. The NHS IC also produces a wide range of statistical publications each year across a number of areas including: primary care, health and lifestyles, screening, hospital care, population and geography, social care and workforce and pay statistics.

2. The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP hosts the contract to manage and develop the National Clinical Audit and Patient Outcomes Programme (NCAPOP. The programme comprises 28 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions.

3. Figures have been rounded to the nearest 10

4. Heart failure is a condition in which the heart has lost the ability to pump enough blood to the body's tissues. With too little blood being delivered, the organs and other tissues do not receive enough oxygen and nutrients to function properly. The most common causes of heart failure are: coronary artery disease and heart attack; cardiomyopathy; high blood pressure (hypertension); heart valve disease; congenital heart disease; excessive alcohol consumption.

5. The main purpose of the audit is to measure the quality of care and clinical outcomes. This provides healthcare professionals with the data they need to make comparisons between Trusts or Health Boards and bring about improvement where necessary. Ultimately this will help drive improvements in care for patients

6. The 2009/10 Quality Outcome Framework (QOF) shows that approximately 393,000 people were on General Practice heart failure registers in England and approximately 28,500 in Wales. This equates to between one and two per cent of the population.

7. For media enquires, including interview requests, please call 0845 257 6990 or contact mediaenquiries@ic.nhs.uk