‘Shocking’ cardiac rehab variation
Medwire News: Cardiology experts are calling on NHS Trusts to step up cardiac rehabilitation efforts, after finding "shocking" inequalities across England in uptake of the treatment among patients who have had a myocardial infarction.
Charity HEART UK details these findings and outlines recommendations for improvements in in its report After the event: Getting care right for patients after a heart attack.
Their research suggests that 2100 patients who would benefit from the treatment are not receiving it each year. Although over 95% of providers offer cardiac rehabilitation, the proportion of patients who had accepted invitations to programmes ranged from 36.7% in Mid-Cheshire Hospitals NHS FT to nearly 99.8% in Royal Devon and Exeter NHS FT.
Lack of engagement and effective referral, as well as scarcity of service provision and practical difficulties were all found to be contributors to poor uptake.
Although the content of services generally supports NICE guidance on secondary prevention, it was found that not all providers offer all four phases of cardiac rehabilitation set out in the National Service Framework for Coronary Heart Disease.
The report calls for an interim quality standard for secondary prevention for commissioning post-event care while NICE develops the final standard, and suggests that in future GPs might be incentivised via QOF to encourage patients to take up cardiac rehabilitation.
Dr Henry Purcell, Senior Fellow in Cardiology at the Royal Brompton Hospital, commented: "There is abundant evidence that many UK patients are not participating in these programmes and are not receiving optimal lifestyle and pharmacological interventions to prevent further cardiac events... Hopefully this pragmatic report will be read and acted upon by all UK healthcare professionals."
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By Caroline Price