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London Ambulance Service

London has best cardiac arrest survival rate in England

PERFORMANCE: London has the best cardiac arrest survival rate in England, with patients up to three times more likely to survive in the capital than elsewhere in the country, new figures reveal.

During 2011-12 in London, 30 per cent of the Utstein group of patients – whose cardiac arrest was witnessed, as a result of a heart problem, rather than a major trauma, and whose heart had not completely stopped - were discharged from hospital alive.

This compares to 22.8 per cent in the capital during 2010-11.

South Central Ambulance Trust Foundation Trust, the worst performing in England, according to the figures, had survival rates of just 10.8 per cent. The national median was about 20 per cent.


Ambulance servicePer cent of patients to survive
East of England24.7
North East24
South East Coast23.6
North West22.6
East Midlands20.4
South Western18.7
West Midlands18.3
Isle of Wight17.4
Great Western15.1
South Central10.8

(Source: London Ambulance Service)

London Ambulance Service medical director Fiona Moore said: “To have almost a third of our patients being discharged is absolutely fantastic.

“London’s survival rate is the highest in the country and among the highest comparable figures published in Europe, with only Stavanger in Norway recording better outcomes at 52 per cent.” However, relatively few places in Europe report their performance in this area.

Dr Moore told HSJ “co-operation” between all parts of the system was key to the improvement.

Since 2005 London has had eight heart attack centres which ambulance crews take patients too directly, bypassing other emergency departments. There has also been a focus on stabilising the patient at the scene before they are moved and an increase in incidences of bystanders attempting resuscitation with control room staff often talking them through how to do chest compressions.

There are also 750 defibrillators stationed across London at busy transport hubs and other public places with staff trained to use them.

London Ambulance Service has been focusing on improving survival rates since 1998. However, survival rates for patients in the Utstein group have only been reported nationally in the past year following the introduction of ambulance clinical indictors.

Dr Moore told HSJ the data collection systems in London were more “mature” and this could have affected performance of other ambulance trusts who had not been collecting figures as long.

“Missing a bit of data here and there can be significant because numbers are small. It can be difficult to get the outcome data from hospitals.”

Readers' comments (4)

  • Could this be to do with having so many hospitals in London you are never far from one?

    Unsuitable or offensive?

  • 2.08
    No as Fionna says its to do with having reduced the number of hospitals that heart attack victims are taken to so that they all receive specialist care 24/7

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  • It's been a while since I did anything with cardiac data, but I remember that the small proportion of patients who met the Utstein criteria combined with generally patchy data collection meant my area's performance was calculated using only a handful of cases. Dr Moore's comments at the end of the article serve to reinforce this recollection.

    Without the patient numbers and data completeness figures, it's impossible to draw any real conclusions from the table above.

    London may be performing better than the rest of the country, it may be due to the specialised 24-hour centres, but the data presented don't give us any greater clarity.

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  • Could the Welsh, Scottish and N. Irish Ambulance Services provide similar comparisons? as readers in countries outside England still belong to the NHS and would value it!!

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