National Heart Failure
Audit Newsletter
This month’s newsletter is quite a long one,
so please bear with me! The purpose of the
National Heart Failure Audit newsletter is to
provide regular communication to keep local users of the audit up to date with audit
developments and events.
Please get in touch is there’s anything you
would like included in the next newsletter.
Contact details are on page 5.
2012/13 data entry deadline
Issue 5 April 2013
In this issue
2
Admission & readmission forms
2
Changes to contact details
3
Updates on data definitions
4
Pro forma problems
4
Patient friendly report
distribution
5
National Heart Failure Audit
road show programme
failure are required to submit 20 patients
per month to the audit (240 over the whole
year). If your Trust admits fewer heart
failure patients than this in the year, please
an submit data on the full number of patients.
that As of April 2013, you will be required to
the enter data on all patients discharged with a
can primary diagnosis of heart failure.
The deadline for submitting records for
patients discharged between 1 April
2012 and 31 March 2013 will be 31 May
2013.
If your hospital imports data from
existing local database, please check
your import files are valid before
deadline, to ensure that any problems
be ironed out well in advance.
Please get in touch in advance to inform us
In 2011/12 all Trusts which admit acute if you are having any problems uploading
patients with a primary diagnosis of heart your data.
accessed via the National Heart Failure
Audit application on Lotus Notes, along with
The National Heart Failure Audit has
a pro forma.
developed a survey of hospital facilities,
comprising around 20 questions, in order to Some hospitals have had trouble saving the
obtain more information about the specialist survey, although this problem appears to be
cardiology and heart failure services sporadic, and it is not yet clear why it is
provided at each of the hospitals submitting happening in some cases but not others. If
you have not been able to save the survey,
data to the audit.
please send the completed pro forma to
Please complete the survey by 31 May
Polly Mitchell.
2013, so that the results can be used in
conjunction with the data collected for the Apologies for any inconvenience caused by
2012/13 Annual Report. The survey can be problems saving the form.
Survey of hospital facilities
Page 1
National Heart Failure Audit Newsletter
Issue 4
Standing: changes to admission and
readmission forms’
Admission and readmission
forms
A number of hospitals have found that they
are unable to enter an admission record
which predates an existing admission on the
audit database.
You may have encountered a pop-up
message saying that you can only have one
admission per patient, or that the date of
admission for a readmission record cannot
predate the date of discharge for the
admission record.

Include in the message:
a. The patient’s hospital number
b. The date of admission for the new
admission you wish to enter
c. The date of discharge for the new
admission record.
Marion will change the existing admission
into a readmission record, and create a new
admission record with the admission and
discharge dates that you have provided.
She will contact to let you know when this
has been done. The new record will be
saved as a draft; you can then go back into
Lotus Notes and fill in the remaining
information.
We have recently created a tool to fix this
issue. If you find a heart failure admission
for a patient which predates an admission
which you have already entered onto the
system for that patient, you should do the
Please note that patient identifiable data,
following:
including case record numbers, must be

Send a message via the drop box on
sent via the drop box and not via email.
the NICOR portal to Mary Jacob.
If you have any questions about this

Give the message the title ‘FAO Marion
process, don’t hesitate to get in touch.
NICOR helpdesk (details on p.5) in the
instance of any changes to database users
Please continue to keep us updated of any
or contact details.
changes to the contact details of those
people involved with the audit, so that we
can keep you informed of changes to the
database and important updates relating to
the audit .
Changes to contact details
If someone with access to the National
Heart Failure Audit database leaves the
Trust, goes on maternity leave or is no
longer responsible for the audit, the name
on the Lotus Notes licence and ID file will
need to be changed.
Please contact Polly Mitchell and the
Page 2
National Heart Failure Audit Newsletter
Issue 5
addition to the lead specialist: Heart Failure
Specialist Nurse, other consultant, district or
The definition of some data fields have been
primary care nurse, pharmacist, dietician,
queried by multiple people, so more
physiotherapist, psychologist, primary care
information about some of these fields is
provider, social worker.
provided below.
***
If there are any data items about which you
would like clarification, please contact Polly Field 2.04ai: Which of the following did
Mitchell. If a query about a particular data the patient see
item is recurring, a clarification will be Option ‘1. Consultant Cardiologist’ should
included in the next newsletter, and the be selected if the patient saw a Consultant
application notes will be updated at the next Cardiologist or a Cardiology SpR.
opportunity to include the additional Ideally a heart failure patient should see the
information.
Consultant as well as the SpR.
Updates on data definitions
***
***
Field 2.04a Did the patient receive input Field 15.07 Cardiology follow-up
from a multidisciplinary HF team?
Similarly, if the patient had a follow-up
A heart failure multidisciplinary team (MDT) appointment with a Cardiology SpR, this
is defined in line with the NICE quality question can be answered ‘1.Yes’.
standard for chronic heart failure (http://
Again though, ideally cardiology follow-up
www.nice.org.uk/qs9).
should be with the Consultant Cardiologist.
Quality statement 11: People admitted to
***
hospital because of heart failure receive
input to their management plan from a Field 9.01 Haemoglobin
On 1 April 2013, Pathology Harmony
multidisciplinary heart failure team.
NICE definitions for quality statement 11 changed the standard unit of measurement
can be found on the NICE website: for haemoglobin concentration from g/dL to
g/L.
www.nice.org.uk/qs9.
In the audit, this question can be answered
‘1.Yes’ if there is a heart failure MDT at your
hospital—i.e. a team led by a consultant
with a specific interest in heart failure— and
the patient was seen by any member of the
MDT. This does not have to be the
Consultant
Cardiologist;
field
2.04ai
captures whether the patient has been seen
by the Consultant.
The National Heart Failure Audit cannot
change the units in which it records Hb until
the next dataset revision, planned for April
2014. Therefore please continue to record
Hb in g/dL.
To convert from g/L to g/dL, divide the value
by 10.
The acceptable range for Hb values in the
National Heart Failure Audit is 5 to 20 g/dL.
The heart failure MDT may include, in
Page 3
National Heart Failure Audit Newsletter
Issue 5
The audit pro forma should be used in
conjunction with the application notes
It has been brought to my attention that
(available on the same web page as the pro
some hospitals have not been using the
forma), which give more detailed data
latest version of the pro forma for the
definitions, in order to ensure that accurate
National Heart Failure Audit dataset.
data are being captured.
The correct version of the pro forma is on
The pro forma has been updated in an
the NICOR website: www.ucl.ac.uk/nicor/
attempt to clarify the data definitions. The
audits/heartfailure/dataset. There are excel
form now also includes space to record drug
and word versions of the pro forma
dosages. These are not core data items, but
available.
do provide important information about the
Please note that height, weight, heart rate, benefits of up-titration, so please include
blood pressure and the results of blood them if possible.
tests, ECG and echo are all to be recorded
If you have any comments about the design
on discharge, or the last recorded
or content of the form, or any questions
measurement.
about data definitions, please get in touch.
Pro forma problems
suggestion is for the reports to be
distributed through existing hospital- and
community-based heart failure outpatient
In the last newsletter, we reported that the clinics.
audit has, for the first time, published a
We would like to know whether you would
version of the annual report aimed
be willing and able to distribute patient
specifically at heart failure patients and their
reports to heart failure patients at your
families. This year the report was only
hospital, or if you have any other
published online, as a pdf, but in future
suggestions as to how hard copies could
years we would like to print copies of the
be distributed. If possible could you give a
report to distribute to patients. The pdf of
rough estimate of how many reports you
the 2011/12 patient report can be found at:
might give to patients. This will help us to
www.ucl.ac.uk/nicor/audits/heartfailure/
determine the feasibility of printing the
additionalfiles.
reports, and how many we should print.
The BHF has generously offered to fund the
We also plan to distribute copies of the
printing and distribution of these reports, if
report to hospital PALS and to CCGs, along
the audit can develop a suitable logistical
with copies of the main annual report.
plan for their distribution.
We would be very interested to hear your
One possibility is that the reports could be
thoughts and comments about the best way
given to patients on discharge, at the same
of getting the message about the treatment
time as they are given discharge information
of heart failure and its outcomes across to
and any other leaflets and advice. Another
patients and their families.
Patient friendly report
distribution
Page 4
National Heart Failure Audit Newsletter
Issue 5
National Heart Failure Audit road change and improve clinical practice, or
how data collection processes have been
show programme
The audit is keen to continue its road show
programme across England. If you are
based in any of the following regions, and
would like to help plan a road show , please
get in touch:







North West
Yorkshire and the Humber
East Midlands
West Midlands
East of England
South West
South Central
Road shows usually involve an update from
NICOR and from the National Heart Failure
Audit and a presentation of the latest audit
findings. They also include case studies
from hospitals in the region, showing how
heart failure teams have used audit data to
streamlined and enhanced. Road shows
may also involve workshops to discuss
technical queries or ideas for the
development of the audit, as well as lots of
time for Q&A.
If you, or any of the nurses, cardiologists or
audit staff at your Trust have a case study
that you think could be useful to other
Trusts, please get in touch. If you have any
suggestions for a venue, or can help put
together a list of potential participants, your
input would be much appreciated.
Previous road shows have been very well
received: as well as providing an
opportunity to discuss good practice and
share successes, road shows give you a
chance to address any queries you have
about the audit and discuss obstacles to
participation and high data quality.
Contact the audit
General enquiries
Contact Polly Mitchell with any clinical queries, general questions about the
audit, or regarding any of the articles in this newsletter.
Email: polly.mitchell@ucl.ac.uk
Tel: 0203 108 3927
Technical enquiries
For any technical questions, or problems using Lotus Notes or importing data,
please contact the NICOR helpdesk.
Email: nicor-helpdesk@ucl.ac.uk
Tel: 0203 108 1978
Why have I received this newsletter?
You have been sent this newsletter because you are either registered as a user of the National
Heart Failure Audit database, or because your name is on the National Heart failure Audit distribution list. If you wish to be removed from the list, please inform Polly by reply.
Page 5
National Heart Failure Audit Newsletter
Issue 5