The United Kingdom national congenital heart disease audit

Abstract

The National Congenital Heart Disease Audit was set up as a validated electronic database in 2000 for quality assurance purposes to assess and monitor outcomes after therapeutic procedures on patients with paediatric and congenital heart disease of all ages, with over 100,000 patients currently in the database (60 % post-surgery). Mortality is tracked independently by using unique patient identifiers (NHS number). NICOR has published centre specific comparisons of activity, data quality and survival on its public portal following individual procedures for over a decade, including when units have appeared to be underperforming (web.nicor.org.uk). It now also operates at a local level with onsite near real time monitoring of 30 day mortality and re-interventions. NICOR has begun to publish risk adjusted whole centre comparative outcomes, both using novel risk adjustment methodology developed using the Audit's database. The Audit has been instrumental in improving the prenatal detection of major congenital heart malformations by publishing the regional success rates of antenatal screening.