Heart failure outcomes remain poor with variations in quality of care across the country and a lack of access to specialist management, according to a major national review.

The National Heart Failure Audit report for 2010-11 showed overall heart failure mortality rates were high, with 12 per cent of patients dying during their admission and over 30 per cent dying within a year of discharge. Mortality rates have not improved significantly since 2009-10.

In addition, the audit revealed marked differences in mortality risk dependent on what sort of ward the patient received treatment in. Just 8 per cent of patients on cardiology wards died compared to 14 per cent of those on general and 17 per cent of patients on other wards.

However, the audit found less than half of all patients with acute heart failure were admitted to cardiology wards with only 22% ever seeing a specialist cardiologist.

Additionally, only 47 per cent with a confirmed diagnosis of heart failure were referred to heart failure liaison services on discharge and only 65 per cent were prescribed beta blockers on discharge.

Significantly patients admitted to cardiology wards received beta blockers on discharge than those on general medical wards – 78 per cent versus 63 per cent.

National Heart Failure Audit clinical lead Theresa McDonagh said: “The use of appropriate medications and access to specialist cardiology had striking benefits – both inpatient and one year mortality were lower for those admitted to cardiology wards.”

She added: “The ongoing challenge is to change our current models of care so that all patients admitted to hospital with heart failure have access to specialist cardiology.”

Heart failure represents 5 per cent of all emergency admissions and the condition costs the NHS around £625m.

Around 85 per cent of all NHS trusts and Welsh boards submitted data to the 2010-11 audit, an increase on the 79 per cent the previous year.

The findings contrast with those from the Myocardial Ischaemia National Audit, published earlier this month, which showed that deaths from myocardial infarction had declined by about 40 per cent in the last six years.