Heart patients need better access to psychological support, says award-winning team

A service providing integrated psychological support for heart patients says their approach can help people to recover more holistically, as Siobhan Chan discovers.

28 September 2018, by Siobhan Chan

Joined-up psychological support for heart patients is vital to engaging them successfully, according to a team that won the Integrated Care prize at the BHF Alliance Awards 2018.

The Peterborough Cardiac Rehabilitation Service and Psychological Wellbeing Service have worked together to provide psychological treatment for people with cardiovascular disease (CVD) or who are recovering from a heart event.

They were presented with the BHF Alliance award for ‘breaking down organisational barriers to put the patient at the centre of care’ at a ceremony in Manchester in June 2018.

Iona McAllister, Cardiac Rehabilitation Coordinator at North West Anglia NHS Foundation Trust, said: “Patients with CVD can often have multiple co-morbidities with numerous hospital appointments, so if we can join up care it may reduce stress at an already stressful time.

“Having integrated services means multiple healthcare professionals can engage with patients during their programme.”

The BHF Alliance Awards took place at the British Cardiovascular Society Annual Conference 2018 and celebrated inspirational work that improves care for heart patients. They are judged by a panel of cardiology and healthcare experts.

Holistic recovery

People with a range of heart and circulatory diseases are two to three times more likely to have depression, and anxiety problems are also common.1

The teams in Peterborough have developed a rapid-access referral pathway for local patients with coronary heart disease to access cognitive behavioural therapy.

The psychological wellbeing service also delivers educational sessions for people attending cardiac rehabilitation on emotional and psychological wellbeing, in which they provide details on how to access individual psychological treatment if required.

The teams report that working together has helped to remove barriers associated with attending a specialist mental health service, thereby decreasing stigma, reducing cancellations and ‘did not attends’.

“This service literally looks after hearts and minds,” said Iona. “We aim to not only look after their physical health but look after their mental wellbeing and enable patients to recover holistically from their cardiac events.”

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Accessible service

The service was one of the ‘early implementer sites’ funded by NHS England to develop integrated psychological therapy services for people with diabetes, CVD and respiratory disease. The service has now received continued funding.

“Making services accessible and integrated alongside motivated enthusiastic staff has ensured this service has had the desired impact on the local health economy,” Iona said.

NHS Cambridgeshire and Peterborough Clinical Commissioning Group has reported savings of £193,000 across the cardiovascular, diabetes and respiratory pathways in the first months of the service, from October 2016 to September 2017.

In this period, the model has saved £122,000 in hospital admissions, which fell by 75%, and £5,300 in A&E attendances, which fell by 61%. GP appointments also fell by 73%.

Award-winning team

“It was an absolute pleasure to win the [BHF Alliance] award,” Iona said. “Both teams have given 100% to make this project work with enthusiasm and professionalism which has ensured its success.”

Vanessa Godden, senior clinician for the service, said “We are constantly striving to innovate and drive the service forward and it’s incredibly rewarding to know that this work is so valued.”

The service has now started an evening class for cardiac rehabilitation at the hospital to help improve uptake for patients who have returned to work.

“It has proved hugely popular, with many commenting they would not have been able to attend if it wasn’t for the evening sessions, and it has helped improve their confidence with exercise,” Iona said. 

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1. Nayor et al (2012) Long Term Conditions and mental health: the cost of co-morbidities. King’s Fund https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/long-term-conditions-mental-health-cost-comorbidities-naylor-feb12.pdf