National Heart Failure Audit - 2007

This report contains information from 719 patients from seven hospital units, relating to 691 initial visits and 120 follow up visits.

The pilot phase highlighted a number of challenges and amendments that need to be addressed before the audit is rolled out at a national level. These are set out in full in the main report but include the following points.

To ensure audit data is representative of care in all organisations, it is essential that the quality of care for all relevant patients admitted to hospital is recorded.

The core mandatory dataset reflects key investigations and interventions highlighted in the NSF and NICE guidelines. The number of completed fields varied and considerable effort will be required to ensure hospitals submit to a satisfactory standard of data completion. For example, the NSF and NICE guidelines emphasise the importance of a confirmed diagnosis of heart failure and access to key investigations such as electrocardiogram (ECG) and echocardiogram. In the pilot, ECG was recorded in 29 per cent of cases and 18 per cent of cases received an echocardiogram. Likewise, the NSF and NICE set out guidelines on the use of drugs such as ACE inhibitors, diuretics and Beta-blockers to enhance life expectancy, improve symptoms and help reduce hospital admission. Information on key drug therapies was reported in only 31 per cent of cases increasing to 50 per cent for newer cases.

In a small number of cases, information may be unknown at the time of data input. However, clinical practitioners are required to keep clear, accurate, legible and contemporaneous patient records which report the relevant clinical findings, the decisions made, the information given to patients and any drugs care and treatment prescribed, together with the patient's response to treatment.