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Published on: June 10, 2025

Overview of findings from the UK and Ireland National Advanced Heart Failure Audit 2024

Owais Dar1,2, Mansimran Singh Dulay3,2, Stephen James Pettit4

  • 1Guy's and St Thomas' NHS Foundation Trust Heart Lung and Critical Care Clinical Group, London, UK o.dar@nhs.net.

Open Heart
|June 2, 2026
PubMed

Insights

The UK and Ireland National Advanced Heart Failure Audit reveals significant regional disparities in access to advanced heart failure (AHF) therapies like heart transplantation (HTx) and left ventricular assist devices (LVAD). Further investigation is needed to address referral barriers and ensure equitable patient care.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Health Services Research

Background:

  • Over one million people in the UK have heart failure, with 200,000 new diagnoses annually.
  • Fewer than 325 heart transplantation (HTx) or left ventricular assist device (LVAD) procedures are performed yearly in the UK and Ireland, despite existing life-saving treatments.
  • A significant gap exists between eligible patients and the number receiving advanced heart failure (AHF) therapies, suggesting under-referral.

Purpose of the Study:

  • To conduct the first UK and Ireland National Advanced Heart Failure Audit.
  • To promote quality improvement in AHF patient care.
  • To examine referral patterns for HTx and LVAD therapies across seven adult heart transplant centers.

Main Methods:

  • The Transplant Cardiology Working Group performed a multicentre audit of referral patterns.
  • Data was collected from seven adult heart transplant centers in the UK and Ireland.
  • Referral rates were analyzed, adjusting for age eligibility and considering factors like distance and deprivation.

Main Results:

  • Approximately 100 referrals per month for transplant or LVAD assessment were identified.
  • Referral rates varied significantly by region, independent of distance to transplant centers or patient deprivation levels.
  • Women are under-referred, making up only one-third of patients assessed for AHF therapies; contraindications were also noted in a considerable number of referred patients.

Conclusions:

  • The audit provides the first evidence of potential inequity in access to AHF therapies across the UK and Ireland.
  • Findings highlight the need for national healthcare planning, including workforce development and resource allocation.
  • Further research is required to understand referral barriers, improve clinician awareness, and optimize care pathways for AHF patients.
Abstract

Keywords:
Delivery of Health CareEPIDEMIOLOGYHEART FAILUREHeart-Assist DevicesTRANSPLANTATION

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