President, Society for Cardiothoracic Surgery, Great Britain and Ireland
Every heart operation is where an individual puts their trust in the surgical team: to get them through surgery safely; to improve their symptoms; to improve their quality of life; to prolong their life. Every patient has great courage to consent to have their heart operation.
Cardiac surgical teams in the UK have accepted their responsibility to be accountable to the patients they serve, the vast majority of whom are treated by the National Health Service.
Transparency in care
The NHS in the United Kingdom can be proud of the quality of its cardiac surgery. No other nation has such a complete audit of its cardiac surgery, since 2005 all the activity and outcomes have been transparent and published.
These results have shown that survival after heart surgery is world leading and that survival has improved over the last 20 years, despite the patients undergoing cardiac surgery being older and sicker. This is described in our latest SCTS Blue Book.
Looking to the future
Looking forwards, there can be justified optimism that reporting and reviewing other outcome measures beyond survival will result in further quality improvement.
In the last year, COVID-19 has caused around a 50% reduction in cardiac surgery and the coming months will be challenging as demand for such surgery returns. However, as every heart operation needs an intensive care bed for safe recovery, we have to be cogniscent and compassionate for our intensive care medical and nursing colleagues who have endured so much in the last year. It would be unreasonable to expect them to return to full activity too quickly.
These results have shown that survival after heart surgery is world leading and that survival has improved over the last 20 years, despite the patients undergoing cardiac surgery being older and sicker.
To help lessen the demand on intensive care, all cardiac surgical teams should carefully consider embracing Enhanced Recovery After Surgery (ERAS). This improves the patient experience, decreases complications, length of stay in hospital and the time needed to be spent in intensive care.
As the years have progressed, the national audit has shown more and more consistent high-quality outcomes across the whole nation. The surgical teams and the surgeons are achieving excellent results and patients can be more assured than ever of the service they receive.