National Pulmonary Hypertension Audit, 15th Annual Report

It is a pleasure to present the 15th National Audit of Pulmonary Hypertension annual report.  It has been a privilege to be part of the audit project board and to have witnessed its evolution over the years.  Since its inception,  a great strength of the audit has been its inclusive approach, encompassing patients regardless of geography or age – making it truly unique.  The NAPH started simply, by describing the patient population and how they were treated.  It very quickly moved from reporting on the process of healthcare to trying to capture quality of care by developing standards in partnership with patients.  These national standards aim to capture important steps in the patient pathway such as timely assessment, diagnosis and treatment.  We hope that their transparent reporting provides reassurance to patients at a time when healthcare systems are under pressure.  Most importantly, the audit also has a role in driving improvement through enhancing current standards and introducing new ones as healthcare evolves and our aspirations grow.  Finally, readers will notice changes in how we present the audit, particularly through the new dashboard feature.  In the coming year, we will make further enhancements to allow greater exploration and interaction with the data.  Yet while the audit develops year on year, one thing remains a constant: at its core, the NAPH reflects the UK’s approach to pulmonary hypertension care - a community of people, patients and their representatives, commissioner's and clinicians working together to improve care. This gives me cause for great hope.

Dr Shahin Moledina, Consultant Paediatric Cardiologist, Lead Clinician for National Paediatric Pulmonary Hypertension Service UK 

The NAPH sets out to measure the quality of care provided to people referred to PH services in Great Britain (England, Scotland, Wales) by answering a number of questions:

The Audit answers these questions through the measurement of a number of professionally-agreed National Standards reported at a national and centre level. 

This report is of particular interest to commissioners and healthcare providers to monitor the quality and effectiveness of PH services. It may also be of interest to researchers and charities working on this subject and to members of the public, including those with PH.

• Data is collected and submitted by hospital staff at PH services in Great Britain. Efforts continue to be made to incorporate Northern Ireland into the Audit.
• The Audit is delivered by NHS England in collaboration with NHS Scotland, NHS Wales (GIG Cymru), the Pulmonary Hypertension Association UK (PHA UK) and the National Pulmonary Hypertension Centres of United Kingdom and Ireland Physicians' Committee.
• Please see the Data quality statement for information on data quality.

The 15th Annual Report demonstrates that more patients with suspected pulmonary hypertension are being referred to specialist centres in the United Kingdom and more patients are being commenced on therapy directed at the pulmonary vasculature than at any time since the inception of the audit in 2009.

Despite year-on-year increases in activity and pressures on resources within the NHS, the UK National Network continues to provide high-quality care, as assessed by performance against the national audit standards. This reflects the hard work and dedication of professionals throughout the NHS, working in partnership with people living with pulmonary hypertension and the UK patients’ association, the PHA UK.

The national audit also includes important data on demographics, the forms of pulmonary hypertension seen at national centres, survival outcomes and the drugs used to treat people living with this condition. Key facts from the national audit are highlighted below, but we recommend readers interact with the NAPH dashboard, where performance against national standards can be reviewed in more detail and compared to previous years. In addition to the data presented, centres are currently collecting more information on the presence of co-morbidities; in the future, this will help to improve our understanding of how these impact on outcomes. 

Whilst audit programmes, such as the UK National Audit of pulmonary hypertension, do not provide solutions to the challenges we face in clinical practice, they do highlight how we are using our current resources and the quality and equity of care that is provided. The results of this year’s audit should provide re-assurance to people living with pulmonary hypertension that the UK National Network continues to provide high quality care.

Professor David G Kiely, NAPH Clinical Lead