National guidance for improvement to the follow-up and surveillance of patients with valvular heart disease

Guidance supporting clinicians, sonographers and service managers to standardise their approach to the follow-up and surveillance of patients with valvular heart disease is now available from the Getting It Right First Time (GIRFT) programme.

The new GIRFT guidance outlines a consistent, evidence-based framework to guide clinical decision-making to support more effective follow-up. It demonstrates a clear approach to the prioritisation of valve clinic outcomes, follow-up categorisation and echocardiographic surveillance intervals, based on the severity of the condition, patients’ haemodynamic status and clinical context.

Advice on clinical presentations, escalation processes and standard text responses across the four triage tiers (urgent red, red, amber and green) is also included, along with specific advice for:

• aortic stenosis (AS) of the bicuspid aortic valve;
• aortic regurgitation (AR) and mitral regurgitation (MR);
• mitral stenosis (MS);
• right-sided valve disease;
• surveillance following valve replacement and repair.

The guidance is clear that the advice should be used alongside clinical judgement, local operational pathways, and current British Society of Echocardiography (BSE) and European Society of Cardiology (ESC) valvular heart disease guidelines.

Click to access GIRFT’s valve follow-up and surveillance guidance >

Dear Colleagues,

We are delighted to share NICOR’s NCAP 2026 Interim Summary Reports, published today, 18 June 2026. Please find attached a letter from the NICOR Senior Management Team, which we encourage you to read in full alongside the reports themselves.

The National Cardiac Audit Programme (NCAP) represents one of the most comprehensive and clinically important sources of cardiovascular outcomes data. These interim reports analyse submissions covering the period 1 April to 30 September 2025, the first two quarters of the 2025/26 financial year and reflect the dedicated work of thousands of clinicians and healthcare professionals across the country.

The findings offer both cause for encouragement and important areas for collective action. There are positive signs of progress: waiting times for elective cardiac surgery have fallen, treatment times for patients with ST-elevation myocardial infarction (STEMI) show marginal improvement, and the growth of ablation procedures for atrial fibrillation reflects the continued innovation. Complication rates across several procedure registries remain reassuringly low.

At the same time, the reports highlight areas where concerted effort is still needed. Self-presentation to hospital among patients with suspected heart attack rather than calling an ambulance continues to rise, with real consequences for treatment times and outcomes. Data completeness remains inconsistent across a number of clinical domains, and some hospitals have yet to register with NICOR for newer structural heart disease procedure registries. The UK also continues to fall behind international guidelines in certain areas, including the use of newer antiplatelet therapies in percutaneous coronary intervention.

NICOR’s audit data exists to serve you and, ultimately, your patients. It is only as powerful as the data that underpins it. We therefore ask that all hospitals ensure they are meeting their commissioner requirements for complete and timely data submissions. If your team requires support, please do not hesitate to contact us at nicor.auditenquiries@nhs.net.

To read the NCAP 2026 Interim Summary Reports in full, and to download the key highlights document, please visit the NCAP webpage at www.nicor.org.uk/national-cardiac-audit-programme. To view the interactive 2026 interim summary reports for each clinical domain visit: www.nicor.org.uk/interactive-reports/2026-interim-summary-reports.

We are grateful for your continued commitment to improving cardiovascular care for patients. This work is vital, and the data you provide helps make improvements possible.

Yours sincerely,

NICOR Senior Management Team 

The eagerly awaited results of the  CHIP-BCIS3 trial (of Impella use in patients undergoing high-risk percutaneous coronary intervention) are now in print in the New England of Medicine!

Dear colleagues,

NICOR is pleased to announce the publication of our second 2025 National Cardiac Audit Programme (NCAP) Annual Report, along with the accompanying patient and public report and 10 interactive clinical domain summary reports.

The reports cover the period of 1 April 2024 to 31 March 2025, and from 1 April 2022 to 31 March 2025 for those analyses covering a three-year period.

The information is available for hospitals, commissioners, regulators and the public, with the aim of improving patient wellbeing, safety and outcomes.

You can find out more and access the reports on our website.

Kind Regards,

Anthony Bradley, Senior Delivery Manager – National Institute for Cardiovascular Outcomes Research (NICOR)