Quality statement 6: Programme of cardiac rehabilitation

Quality statement

Adults with stable chronic heart failure are offered an exercise‑based programme of cardiac rehabilitation. [2011, updated 2016]

Rationale

Programmes of cardiac rehabilitation can help to extend and improve the quality of a person's life through monitored exercise, emotional support and education about lifestyle changes to reduce the risks of further heart problems. They can also reduce uncertainty and anxiety about living with chronic heart failure and, through better management of their condition, the person may have greater opportunities to return to normal activities. Offering an exercise‑based programme of cardiac rehabilitation to all adults with chronic heart failure when their condition is stable, will help to prevent the person's heart failure from worsening, reduce their risk of future heart problems and improve their quality of life.

Quality measures

Structure

Evidence of local arrangements to ensure that adults with stable chronic heart failure are offered an exercise‑based programme of cardiac rehabilitation.

Data source: Local data collection.

Process

Proportion of adults diagnosed with stable chronic heart failure who have been referred to an exercise‑based programme of cardiac rehabilitation.

Numerator – the number in the denominator who have a record of referral to an exercise‑based programme of cardiac rehabilitation.

Denominator – the number of adults with stable chronic heart failure.

Data source: Local data collection.

Outcome

a) Rates of uptake of and adherence to programmes of cardiac rehabilitation.

Data source: Local data collection. National data on the uptake of cardiac rehabilitation are available from the National Audit of Cardiac Rehabilitation.

b) Patient experience of programmes of cardiac rehabilitation.

Data source: Local data collection. National data on the uptake of cardiac rehabilitation are available from the National Audit of Cardiac Rehabilitation.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (such as GP practices, community nursing teams and hospitals) ensure that exercise‑based programmes of cardiac rehabilitation that include a psychological and educational component are available for adults with stable chronic heart failure.

Healthcare professionals (such as GPs, cardiac rehabilitation nurses and specialists in cardiac care) ensure that they offer adults diagnosed with stable chronic heart failure an exercise‑based programme of cardiac rehabilitation, once they are well enough to attend.

Commissioners (such as clinical commissioning groups, local authorities and NHS England) ensure that they commission services in which exercise‑based cardiac rehabilitation programmes, that include a psychological and educational component, are offered to adults with stable chronic heart failure.

What the quality statement means for patients, service users and carers

Adults with chronic heart failure that isn't worsening are offered an exercise‑based programme of cardiac rehabilitation that is designed for people with heart failure, if it is suitable for them and once they are well enough to attend. This programme will include help and support with taking exercise, understanding their condition and how to look after themselves.

Source guidance

Definitions of terms used in this quality statement

Programme of cardiac rehabilitation

This is an exercise‑based programme of rehabilitation designed for people with heart failure that includes a psychological and educational component.
[Adapted from Chronic heart failure in adults (NICE guideline CG108) recommendation 1.3.1.1]

Equality and diversity considerations

A programme of cardiac rehabilitation should be available for all adults with stable chronic heart failure, including those who may be house‑bound or in a nursing home. To ensure equality of access to rehabilitation programmes, measures such as providing transport for people to attend sessions and holding the sessions in different locations should be considered. Cardiac rehabilitation should be held in centres that have access for disabled people.

Healthcare professionals should take into account the communication needs of people with stable chronic heart failure, including those with cognitive impairment, when delivering cardiac rehabilitation. All information should be culturally appropriate, and accessible to people with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English. People should have access to an interpreter or advocate if needed.