Survival and support
Pandemic sees drop in heart patients taking up life saving aftercare sessions
There were 12,400 fewer people participating in cardiac rehabilitation programmes during 2020, when the Covid-19 pandemic first took hold, as significant numbers of staff were redeployed to meet pressures from the coronavirus pandemic, according to the new National Audit of Cardiac Rehab (NACR) report.
The report, which we fund, showed the greatest fall in participation was among ethnic minority groups, where eleven per cent fewer patients took up cardiac rehabilitation in 2020 compared to 2019.
Meanwhile, participation amongst women and men fell at similar rates (by eight per cent in males and nearly six per cent in female heart patients). To address this decline in participation, the latest report is calling for cardiac rehab to be delivered in a way that best suits the individual patient’s needs.
The redeployment of NHS staff during the pandemic, alongside the suspension of services during Covid-19, has had a significant effect on how cardiac rehab has been delivered.
Almost 80 per cent of cardiac rehab programmes across England, Northern Ireland and Wales had some or all of their team redeployed from January to December 2020.
Considerable impact
The impact that this has had on cardiac rehab has been considerable, with 12 per cent of programmes ceasing to run completely due to full staff redeployment in their teams.
About 67 per cent of programmes had key members of their team redeployed, which resulted in limited support for cardiac rehab services.
A knock-on effect of this was a reduction in the number of people being referred to, taking up, and completing cardiac rehab.
Only around 21 per cent of programmes were unaffected by redeployment, although these programmes still would have been affected by the reduced patient throughput due to Covid-19 restrictions and reduced cardiology referrals.
The implications of not participating in the service following a cardiac event could be life threatening.
Research has shown that cardiac rehab reduces the risk of premature death by a quarter and lowers hospital admissions by around a fifth, it also reduces the chances of a further serious heart-related illness, so it’s extremely important that the people who are offered the service are able to access it.
The pandemic also saw a major shift in the way people were accessing cardiac rehabilitation, with home-based delivery now overtaking group delivery as the dominant mode of cardiac rehab.
Home-based cardiac rehab only made up 16 per cent of delivery modes prior to the pandemic, but this has increased to 76 per cent. Meanwhile, group-based cardiac rehab fell from 72 per cent to 16 per cent from 2019 to 2020.
Vital part of recovery
Ruth Goss, our Senior Cardiac Nurse, said: “These findings are further evidence of the significant knock-on impact the pandemic is having on cardiac care. Cardiac rehab is a vital part of recovery for many cardiac patients.
"Whilst it is a welcome step in the right direction to see innovation that allows those who can receive cardiac rehab in their own home, it is concerning to see such a large overall drop, and that ethnic minority groups appear to face disproportionately reduced access to cardiac rehab.
“The reasons for ongoing inequalities in cardiac rehab are complex, and there are multiple reasons why people aren’t attending. One size does not fit all, and if we want more patients to benefit from cardiac rehab, then we need to make it both easy to access and available in a form useful to patients.”
Professor Patrick Doherty, Director of the NACR report, said: “It’s hugely important that everyone who needs cardiac rehab is able to access it. However, these worrying figures show that, once again, people who may need cardiac rehab the most aren’t always attending.
“Now more than ever cardiac rehab needs to be tailored to the individual’s needs and preferences. This includes making sure that everyone who needs it can access it, whether that be in person or online, regardless of their age, gender, ethnicity or socioeconomic background.”