POPULATION DATA

Localised heart failure prevalence has been calculated by applying the age-specific estimates of heart failure crude prevalence from The Lancet article by Conrad et al. (2018)1, "Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals" to CCG populations.2

For example, if there are 5,736 people aged 65-69 in NHS Barking and Dagenham CCG, it is assumed that 2.5% of them will have heart failure which equals to 146 patients. This is repeated for all age groups and aggregated together at CCG level.

Heart failure prevalence is presented at three time points:

  • 2002 (i.e historic prevalence) using 2002 benchmarks in Conrad et al. (2018)1 and ONS Mid-2002 Population Estimates for CCGs3
  • 2018 (i.e. latest prevalence) using 2014 benchmarks in Conrad et al. (2018)1 and ONS Mid-2018 Population Estimates for CCGs4
  • 2025 (i.e. projected prevalence) using 2014 benchmarks in Conrad et al. (2018)1 and ONS 2018-based Subnational Population Projections5

National average prevalence figures are presented - these represent the average per organisation within England.

An 'average sized CCG' in England has been defined here as the mean population size of all CCGs in England. This has been calculated by dividing the total England population (using ONS Mid-2018 Population Estimates for CGGs) by the number of CCGs in England.

HOSPITAL ADMISSIONS 2019/20

A count of the number of hospital admissions where heart failure has been recorded as either a primary or secondary diagnosis in the admission episode, defined using the following ICD-10 codes:6

'I110 - Hypertensive heart disease with (congestive) heart failure

'I255 - Ischaemic cardiomyopathy

'I420 - Dilated cardiomyopathy

'I429 - Cardiomyopathy, unspecified

'I500 - Congestive heart failure

'I501 - Left ventricular failure

'I509 - Heart failure, unspecified

Data has been split by admission method (elective or non-elective), gender and broad age group. Trend data for four years (2015/16 to 2019/20) is also presented alongside the percentage change over the five-year period (2015/16 to 2019/20).

Readmissions are defined as non-elective admissions to hospital within 28 days of a patient's discharge where heart failure was a primary diagnosis in their initial (i.e. preceding) admission and is recorded in any diagnosis position in their readmission (i.e. the subsequent admission).

The average number of hospital admissions per CCG in England has been calculated by dividing the total number of hospital admissions where heart failure has been recorded as either a primary or secondary diagnosis in England in 2019/20, by the number of CCGs in England.

COSTS

The data in this section shows the indicative cost of hospital admissions where heart failure has been recorded as either a primary or secondary diagnosis in the admission episode. Cost have been calculated using the National Tariff Payment System 2019/207 based on HRG code, admission method and length of stay. A Market Forces Factor (MFF) has been applied.*

Data has been split by admission (elective or non-elective), gender and broad age group.

*A Market Forces Factor is the percentage uplift to the tariff, depending on where in England the NHS Trust is based. It estimates the unavoidable cost differences between healthcare providers in different parts of the country.

The average cost of hospital admissions per CCG in England has been calculated by dividing the total cost of hospital admissions where heart failure has been recorded as either a primary or secondary diagnosis in England in 2019/20, by the number of CCGs in England.

MORTALITY

Mortality in heart failure patients is represented within the map by data drawn from CCG Outcome Indicator "1.21 All-cause mortality – 12 months following a first emergency admission to hospital for heart failure in people aged 16 and over".8

The map shows the number of recorded deaths from any cause in the 12 months following the first hospital attendance of an individual with a recorded primary diagnosis of heart failure, covering the period 2015/18.

The ‘indicator value’ is calculated as a ratio indirectly standardised by age and sex (England has a ratio of 100). The figure sets out the standardised mortality rate of expected heart failure deaths in a local area, based on the demographic composition and associated benchmarks of specific gender-age groups. The figure is based against the number of deaths due to heart failure recorded at a national level during this period.

Because this indicator uses indirect standardisation it is not appropriate to make year-on-year comparisons or to compare CCGs with other CCGs. CCGs should only be compared to the national figure within the same reporting period.

Recently merged CCGs are not included in the dataset - therefore mortality numbers have been calculated by aggregating former CCG data and indicator values are based on weighted averages.

MAP LIMITATIONS

It is important to note that this map presents a mixture of ‘actual’ and ‘estimated’ heart failure data, as well as data drawn from different time periods. Further information on the data included within each individual map section is set out in the supporting methodologies below.

'Actual' data

The following data presented in the map are based on actual recorded data:

  • Hospital admission data (published by NHS Digital)
  • Mortality data (published by NHS Digital)
  • Population data (published by the Office for National Statistics)

'Estimated' data

Local heart failure prevalence data included in the map are estimates which are based on the heart failure crude prevalence figures established from Conrad et al. (2018)1 ,which are given at age group level. These estimates have been applied to local Clinical Commissioning Group (CCG) populations based on their age structures.

Indicative heart failure-related costs included within the map have been calculated using the National Tariff Payment System 2017/18 and are based on the Healthcare Resource Group (HRG) code, admission method and length of stay of each recorded hospital admission.

Map data time periods

Datasets included within the map are based on the following time points:

  • Crude prevalence estimates from Conrad et al. (2018)1 are based on 2014 populations
  • Hospital admission data are taken from HES 2019/20
  • Mortality data from NHS Digital covers the entire period April 2015 to March 2018
  1. Conrad et al. (2018). Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals. The Lancet, Volume 391, Issue 10120: 572-580.
  2. Data on file.
  3. Office for National Statistics. Mid-2002 to Mid-2010 Population Estimates for Clinical Commissioning Groups (CCGs) in England by Single Year of Age and Sex; based on the results of the 2011 Census.
  4. Office of National Statistics. Mid-2018 Population Estimates for Clinical Commissioning Groups (CCGs) in England by Single Year of Age and Sex.
  5. Office for National Statistics. 2018-based Subnational Projection Figures for England.
  6. ICD-10 Version: 2010.
  7. NHS England, National Tariff Payment System (2019/20).
  8. NHS Digital, CCG Outcomes Indicator Set (2019/20).
 

CVM19-C027j August 2020

Fighting Failure is a disease awareness campaign that has been sponsored and funded by Novartis Pharmaceuticals UK Ltd.

© 2020 Novartis Pharmaceuticals UK Ltd.

Novartis Pharmaceuticals UK Limited is a private limited liability company registered in England and Wales under number 119006 Registered office 2nd Floor, The WestWorks Building, White City Place, 195 Wood Lane, London, W12 7FQ.

Reporting side effects
If you get side-effects with any medication you are taking, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the information leaflet that comes in the pack. You can report side effects via the Yellow Card Scheme at https://yellowcard.mhra.gov.uk/ (UK).
By reporting side effects you can help provide more information on the safety of your medication.

CVM20-C007q August 2020