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Quality of cardiac rehab questioned by researchers

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The majority of cardiac rehabilitation services are failing to meet minimum standards for patient care, according to new research.

A study, funded by the British Heart Foundation and published in the journal Open Heart, found just under 16% of programmes met all six key national standards for post heart attack services.

“Programmes that are failing to meet any of the standards are perhaps beyond repair”

Patrick Doherty

Researchers assessed 170 programmes across England, Wales and Northern Ireland. They identified less than a third – 31% – as high-performing because they met at least five of the standards, which cover patient access, waiting times and the length of rehabilitation.

They found 46% were middling, meeting three or four criteria, while the performance of 18% was low, meeting just one or two of the core standards.

Meanwhile, 5% of services did not meet any of the minimum standards and had “failed” altogether. Just 15.9% – 27 out of the 170 schemes – achieved all six standards.

Cardiac rehabilitation, often delivered by nurses, includes practical advice and help to recover and reduce risks of further heart attacks such as exercise classes and guidance on healthy eating. Services can play a vital role in cutting the number of deaths and hospital readmissions.

The researchers said their study showed it was possible to deliver a high-quality service, but it was “worrying” how many programmes were not even achieving basic standards.

“It is clear from the high-performing programmes that quality service delivery is achievable,” said study co-author Professor Patrick Doherty, from the University of York.

“It is possible that many of the mid-level performing programmes could improve if more patients were assessed and rehabilitation was delivered earlier,” he said. “The worry is that programmes that are failing to meet any of the standards are perhaps beyond repair.”

British Heart Foundation

Dr Michael Knapton

Mike Knapton

Dr Mike Knapton, associate medical director at the British Hearty Foundation, described the study findings as “worrying”.

“This research shows the worrying extent to which cardiac rehabilitation services are failing heart patients across the UK, putting them at increased risk of having another potentially fatal heart attack,” he said.

“These services are paramount in a patients’ physical and mental recovery and the programmes which are meeting recommendations help save lives,” he noted.

He added: “Services across the UK need to ensure that at the very least, they are meeting the basic, minimum national standards of care that every heart attack patient should expect to receive.”

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