Understaffing Risks Heart Attack Patients In UK
UK heart charity campaigns to increase support and resources for heart patients and particularly for those who have suffered heart attack.
A new report published today by the British Heart Foundation (BHF) (1) failed to find a single cardiac rehabilitation programme in the UK which is meeting minimum staffing levels depriving patients of life-saving care (2).
The 2008 National Audit of Cardiac Rehabilitation found that the average patient receives just 79% of the recommended nursing time, 36% of the physiotherapy and just 16% of the professional dietetic support required (3) to meet health service guidelines.
Cardiac rehabilitation gives heart patients a 26% greater chance of surviving in the five years following their diagnosis (4) by providing them with medical and lifestyle advice.
This failure to meet the minimum recommended staffing levels is part of an overall shortfall in the provision of cardiac rehabilitation in many areas of the country. In its National Service Framework for Coronary Heart Disease, the UK Government set a target in 2000, that 85% of heart patients in England should be invited to attend cardiac rehabilitation.
Today’s report found that 55% of programmes were significantly under-funded, and that on average, three out of five heart patients in the UKwho need rehabilitation do not have access to it. As a result, many patients are denied access to this lifesaving treatment, even though cardiac rehabilitation costs just £600 per patient (5).
Mike Knapton, Director of Prevention and Care at the British Heart Foundation, said: “Cardiac rehabilitation saves lives but the majority of patients don’t get the service. We are only making minimal progress towards national targets set over eight years ago. The health service needs to give cardiac rehabilitation the same priority they give to treating people with acute heart attacks.”
The report marks the first anniversary of the BHF’s Cardiac Rehabilitation Campaign which calls for better availability and quality of treatment across the UK.
It shows that whilst some improvements are being made in the provision of cardiac rehabilitation in the UK, and welcome commitments for further progress have been made in the Scottish Government and Welsh Assembly, the majority of UK patients with heart disease are still not receiving this life-saving care.
Currently London has the lowest rate of cardiac rehabilitation for patients who have suffered a heart attack with only 31% of patients receiving treatment. The highest level of cardiac rehabilitation for patients who have suffered a heart attack is in the North East at 52% (6), although this is still falls short of the recommended Government target.
Dr Gail Bohin, a Clinical Psychologist, has been involved in setting up acardiac rehabilitationpilot programme, specifically for patients with Chronic Heart Failure, with Gloucestershire Hospitals NHS Foundation Trust's Cardiac Rehabilitation Service.
"We devised the programme to increase patient's confidence and to help them feel more in control of their CHF, not just with regard to exercise but in terms of their lives in general. We are working towards securing further funding to deliver the programme across the county on a permanent basis but unfortunately until this happens CHF patients in Gloucestershire will not have access to group rehabilitation."
Cardiac rehabilitation involves nurses, physiotherapists, dieticians, psychologists and occupational therapists who work with their patients both one-to-one and in groups.
At the end of the average 12 week programme, patients are able to understand their condition, have greater confidence and able to regain a high quality of life again (7)
Stephen Hamilton, from Twickenham, was not offered cardiac rehabilitation after his heart attack five years ago. He now campaigns to make cardiac rehabilitation available to patients in his region.
“I found the recovery process after my heart attack quite difficult and I think it would have been made easier if I had been offered the support of cardiac rehabilitation. I have since fought hard for the provision of quality cardiac rehabilitation services in my region.
“I know from personal experience the toll that having a heart attack can take both physically and emotionally, which is why I am doing everything in my power to make cardiac rehabilitation more accessible and help make the road to recovery easier for people like me.”
Professor Bob Lewin at the BHF Cardiac Care and Education Research Group and the report’s author said: “Despite heart and circulatory disease being the UK’s biggest killer, many patients face a lottery as to whether they’re referred to a programme and the treatment they get if they attend. Cardiac rehab allows people to have longer and better quality lives.
We will continue to fail heart patients unless the Government and health professionals prioritise funding for this life saving treatment.”
People can visit bhf.org.uk/cardiacrehab to find out how they can make a difference by supporting the campaign, either by signing an online petition or by emailing their MP.
For more information on the campaign please phone the BHF press office on 020 7487 7172 or 07764 290381 (out of hours).
(1) The National Audit of Cardiac Rehabilitation Annual Statistical Report 2008
(2) 95% of CR programmes responded to the annual paper survey. There are a total of 374 CR programmes currently running in the UK (p.7 NACR)
(3) The National Audit of Cardiac Rehabilitation Annual Statistical Report 2008 p.7
(4) Taylor RS, Brown A, Ebrahim S, et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 2004;116:682–92
(5) British Association for Cardiac Rehabilitation (BACR) recommended minimum cost for Cardiac Rehab
(6) The National Audit of Cardiac Rehabilitation Annual Statistical Report 2008 p.40
(7) Quality cardiac rehabilitation programmes include:
* ongoing advice and support from medical professionals
* advice on improving lifestyle and diet
* a structured exercise programme; and
* professional counselling.
- Led by a coalition of organisations including the British Heart Foundation, the British Association for Cardiac Rehabilitation (BACR) and patient groups, the campaign is calling for:
1. Cardiac rehabilitation for every suitable heart patient who wants it
2. Every cardiac rehabilitation programme to meet the minimum standards
3. Equal uptake of cardiac rehabilitation for all groups of people, including women and ethnic minorities
4. An offer of home-based cardiac rehabilitation if preferred to group programmes or hospital programmes as an outpatient
- The national campaign is backed by the British Association of Cardiac Rehabilitation (BACR), Diabetes UK, Heart Care Partnership UK, Primary Care Cardiovascular Society (PCCS), Arrhythmia Alliance – The Heart Rhythm Charity, Sudden Adult Death Trust (SAD), Mental Health Foundation, British Cardiovascular Society.
- In Scotland the campaign is being run in partnership with Chest, Heart & Stroke Scotland (www.chss.org.uk) and is backed by the British Association of Cardiac Rehabilitation (BACR) and Cardiac Rehabilitation Interest Group Scotland (CRIGS).
- For detailed breakdowns of the rates of cardiac rehabilitation in each health authority, please contact the BHF press office.
- The British Heart Foundation (BHF) is the nation’s heart charity, dedicated to saving lives through pioneering research, patient care, campaigning for change and by providing vital information. But we urgently need help. We rely on donations of time and money to continue our life-saving work. Because together we can beat heart disease.