National Heart Failure Audit (reporting on April 2014 – March 2015)
The eighth annual report for the National Heart Failure Audit presents findings and recommendations for patients with an unscheduled admission to hospital, who were discharged or died with a primary diagnosis of heart failure between 1 April 2014 and 31 March 2015. The report covers all NHS Trusts in England and Health Boards in Wales that admit patients with acute heart failure.
The audit report identifies serious gaps in the management of heart failure (HF), across England Wales, including specialist care, correct medication prescription and coordinated specialist care post-discharge.
Key findings include:
- Of the 56,915 heart failure admissions 9% went home not having had the key diagnostic investigation
- Prescription rates for all three key disease modifying medications, in patients with HF and a reduced ejection fraction, has increased to 50% for those admitted to Cardiology wards and for those seen by specialists elsewhere to 45%, but just 20% for those who don’t receive any specialist input
- The individual prescribing rates of beta-blockers and mineralocorticoid antagonists have both increased since the last audit
- Specialist input is most readily delivered on the cardiology ward but overall 80% of all HF admissions, irrespective of place of care, will receive input from one or more members of the specialist HF team
- In-hospital mortality overall was 9.6%, higher in the over 75yrs at 12% and 4.8% in those aged less 75. Mortality on the specialist cardiology ward was lowest at 7.1%, against 10.4% on general medical wards
- Thus the 50% of patients managed on specialist cardiac wards are more likely to survive to discharge, receive key drugs, have timely specialist follow up and more likely to be alive at follow up
