In 2012, the National Clinical Programme for Acute Coronary Syndrome (ACS) published an ACS Model of Care . The aim of the programme was to ensure that all patients with ACS nationally are managed according to the Optimal Reperfusion Service protocol. In order to assure the ACS programme, a performance monitoring mechanism, known as Heartbeat, was established to facilitate improvement in care of ACS patients and so reduce mortality and morbidity through a focus on evidenced-based indicators of care in hospitals across the country. In 2019, governance of Heartbeat was transferred to NOCA with a view to establishing the Irish Heart Attack Audit. The audit is clinically led, collecting high-quality data on ACS patients admitted to Primary Percutaneous Intervention Centres in Ireland for the purpose of healthcare quality improvement.