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National Cardiac Transformation Programme

13 May 2026

Dear Colleagues,

As part of the national cardiac transformation programme, which aims to increase the uptake of minimally invasive cardiac surgery (MICS) and enhanced recovery after cardiac surgery (ERACS) across the UK, the Society for Cardiothoracic Surgery (SCTS) has been working closely with the Cardiac Clinical Reference Group (CRG) at NHS England to improve the capture of MICS activity.

Accurate coding of minimally invasive procedures is essential for several reasons. It will enable us to define the true volume and nature of MICS cases being undertaken across the country, strengthen the case for enhanced reimbursement to reflect the additional costs associated with specialised equipment, and allow us to monitor the impact of these approaches on important clinical outcomes such as length of stay and postoperative recovery.

I am delighted to report that, with effect from April 2026, a new OPCS-4.11 code — Y77.3 — is now available to identify minimally invasive cardiac surgical procedures. The existing code for median sternotomy (Y49.1) remains unchanged and should continue to be used where appropriate.

We plan to review national coding data in September 2026 to assess how widely the new code has been adopted and to evaluate its impact on activity reporting.

In parallel, we continue to work on the development of a Best Practice Tariff for ERACS. This includes defining a set of measurable standards that can be used to capture and benchmark enhanced recovery after cardiac surgery, with the ultimate aim of establishing these measures as the foundation of a future tariff.

Minimally invasive surgery and ERACS remain two of the key pillars in the transformation of cardiac surgery in the UK. Both have the potential to improve patient outcomes, reduce length of stay, and enhance the efficiency and sustainability of our services. We strongly encourage all units to adopt these approaches wherever feasible.

We also hope to launch the second wave of sites participating in the SCTS/ACTAAC programme in the coming months.

Thank you for your continued support and engagement in this important work.

With best wishes,

Professor Enoch Akowuah

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