More than two-thirds (70%) of heart attack programmes are failing to meet the minimum requirements for patient care, according to research funded by the British Heart Foundation (BHF).
Cardiac rehabilitation services can help heart attack patients recover and reduce their risk of another major heart event. There are hundreds of programmes spread across the UK and the majority are based at hospitals.
The study, published in Open Heart, is the first of its kind and assessed 170 programmes across England, Wales and Northern Ireland, and found that just 52 met at least five of the six national minimum standards.
The criteria included meeting minimum standards on patient access, waiting times and duration of rehabilitation.
Researchers from University of York found:
- 31% of programmes met at least 5 of the 6 minimum standards
- 46% met 3 or 4 of the criteria
- 18% met 1 or 2 of the criteria
- 5% failed to meet any of the minimum standards
Around 66,000 heart patients took part in rehabilitation in 2014/15, an increase of 27% since 2009 (51,000) according to the most recent National Audit of Cardiac Rehabilitation (1). This means that half of all eligible patients are now accessing cardiac rehabilitation services for the first time since records began.
Rehabilitation can help reduce the number of deaths by 18 per cent over the first six to twelve months (2) and can cut readmissions to hospital by a third (31%).
It's recommended that heart attack and angioplasty patients start cardiac rehabilitation within 33 days, but just half of programmes are meeting this target.
Cardiac rehabilitation offers physical activity support and lifestyle advice, such as exercise classes and dietary guidance, to help people living with heart disease manage their condition and reduce their risk of associated heart events.
Professor Patrick Doherty, from the University of York, whose work is funded by the BHF, said: "It is clear from the high-performing programmes that quality service delivery is achievable.
"It is possible that many of the mid-level performing programmes could improve if more patients were assessed and rehabilitation was delivered earlier. The worry is that programmes that are failing to meet any of the standards are perhaps beyond repair."
Dr Mike Knapton, Associate Medical Director at the BHF, said: "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.
"These services are paramount in a patients' physical and mental recovery and the programmes which are meeting recommendations help save lives.
"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."
Article: Does cardiac rehabilitation meet minimum standards: an observational study using UK national audit?. Doherty, P. et al., Open Heart, doi:10.1136/openhrt-2016-000519, published 10 January 2017.