39% of heart patients in Wales are missing out on vital recovery care that could prevent them dying prematurely (1), a British Heart Foundation (BHF) report has found.
Cardiac rehabilitation is a programme of exercise, education and psychological support which research has shown can reduce the risk of dying from heart and circulatory diseases by a quarter. It is recommended for people after a heart attack, coronary angioplasty and heart surgery, and is also available to some people with angina or heart failure.
However latest figures reveal that 68,000 out of 136,000 people eligible for cardiac rehabilitation in England, Wales and Northern Ireland did not access this crucial care (2).
The BHF’s 2019 National Audit of Cardiac Rehabilitation (NACR) report highlights that while there has been a slight increase of 2% of patients accessing programmes in Wales since last year and the overall uptake rate is 61%, it still means that 39% of eligible patients (2,407) missed out. (3). The figures show that only 28% of patients who don’t have surgery following a heart attack started a Cardiac Rehabilitation programme, and that the proportion of females that took up Cardiac Rehabilitation out of the total eligible population was only 31%.
NHS Wales supports cardiac rehabilitation for all eligible patients in the country (4), but current trends indicate that without significant innovation and funding, programmes across the country will struggle to meet existing demands and thousands of patients won’t get the support they need.
BHF Cymru believes cardiac rehabilitation should be a priority treatment and must be accessible to all eligible heart patients in Wales and across the UK.
Adam Fletcher, Head of BHF Cymru, said:
“We know cardiac rehabilitation can save lives and improve people’s quality of life, but it isn’t always accessible or flexible enough to work for everyone. Many people in Wales are benefiting from a Cardiac Rehabilitation programme, but only 28% of patients who didn’t have a surgical procedure- known as medically managed patients- following a heart attack, accessed a programme. Unless we reduce these inequalities in terms of access, thousands of people in Wales will continue to miss out.
“Cardiac Rehabilitation needs to be more tailored to the individual patients’ requirements and offer appropriate choices so that this vital aspect of their care can be accessed by all. We are all unique, and recovery care after a heart event, surgery or diagnosis should be too.”
The BHF says it is more important than ever that we know why this is happening and that more research will be necessary to fully understand the reasons for the low uptake rates, and to identify possible solutions.
The charity believes uptake will remain static until more innovative, person-focused ways of delivering cardiac rehabilitation are tried and tested. This will build on strong successes of cardiac rehabilitation services to date, while making options more personalised.
Evidence from clinical trials suggests that programmes focused around the person rather than the service, such as through a digital or home-based programme, can be as successful as group-based programmes. Yet across the UK, fewer than one in ten (9%) cardiac rehab patients are taking up home-based options, compared to three in four (75%) that are attending group-based sessions (8).
Professor Patrick Doherty, Director of the National Audit for Cardiac Rehabilitation, said:
“Wales is leading the way compared to others in the UK and the rest of the world in rehab for some heart patients. For many people, group-based cardiac rehab works in Wales however it’s crucial we don’t rely on a one-size-fits-all approach.
“We want to see recovery care designed around people’s needs that give them access to a range of options that work for them, including home-based and digital programmes.
“This would not only benefit people by helping them to live happier, healthier lives, but also help relieve some of the pressure on the NHS.”
1-3) National Audit of Cardiac Rehabilitation (NACR) 2019
4) All Wales Cardiac Rehabilitation Review (2010)
5-8) National Audit of Cardiac Rehabilitation (NACR) 2019