Cardiac rehabilitation programmes save lives. The research is out there to support the claim along with the testimony of the thousands of patients who have participated in and benefited from them.
OK, I’ll admit I’m biased, as I work as a cardiac rehabilitation nurse specialist. It may not be the sexy end of the plethora of cardiology treatments – I’ve not seen a vial of reteplase for years and I don’t spend my day holding someone’s ribs apart while a surgeon replumbs the coronary blood supply – but I know that what I do matters. If I didn’t do it, the thrombolysers and bypassers would have to repeat their work as coronary artery disease has a habit of coming back.
Even given the evidence that such a service is vital for recovery from CVD, it comes as no surprise that the recent report by the British Heart Foundation, The National Audit of Cardiac Rehabilitation, has found that cardiac rehabilitation services in the UK are woefully understaffed and underfunded.
There are many reasons. The emergence of the heart failure, acute coronary syndrome and arrhythmia nurse specialists has pushed cardiac rehabilitation down the agenda. In addition, technological advances, such as percutaneous coronary intervention, have meant shorter hospital stays for many patients who believe they are cured of CVD.
Perhaps the main reason is a lack of ownership – does the service belong in the community or in a hospital setting?
Professor Bob Lewin, who wrote the BHF’s national audit report, recommends that, among others, those who commission services for the local population could achieve much by ensuring rehabilitation programmes are strengthened to meet the minimum standards.
How could this be achieved? If we charged PCTs £500 for every patient accessing the programme, they would want to make sure they were getting their money’s worth.
According to the BBC, the NHS Confederation, which represents managers, said the BHF’s report would help local areas provide a better service. But is this really the first time managers have heard that a once proud service is struggling? I think not. The BHF needs to continue campaigning to keep this issue alive.
Rob Harteveldt is a cardiac liaison nurse specialist at Stoke Mandeville Hospital
To read more of Rob Harteveldt’s views, click on the more by this author link at the top of the page.