Cardiac rehabilitation
National priority projects 2009-10
NHS Improvement is undertaking some new and important work supporting a number of project sites to help test, sustain and spread improvements in cardiac rehabilitation (CR) services across the country.
The primary aim of this exciting programme of project work is to improve the quality and efficiency of cardiac rehabilitation services for patients and staff by strengthening commissioning arrangements and supporting organisations to deliver the Quality, Innovation, Productivity and Prevention (QIPP) agenda via the implementation of the new DH commissioning pack for cardiac rehab.
Following our initial call for invitations in spring 2010, the following ten sites were selected to join the national project:
| Project Lead Organisation |
| North East London Cardiovascular |
| NHS South of Tyne & Wear |
| Lancs & Cumbria Cardiac & Stroke Networks |
| NHS North of Tyne |
| Liverpool & Sefton PCTs |
| South London Cardiac and Stroke Networks |
| North & East Yorkshire & Northern Lincolnshire Cardiac & Stroke Network |
| University Hospitals Leicester |
| Anglia Stroke & Heart Network |
| Shropshire & Staffordshire Heart & Stroke Network |
The sites - encompassing just under a third of all cardiac networks, one quarter of all PCTs and one fifth of NHS Trusts in England- will be working hard over the coming months to test the utility of the commissioning pack in improving CR services.
Details of forthcoming meetings, and presentations from past meetings can be found on our cardiac rehabilitation events page.
Measures for the national cardiac rehabilitation project
To gauge progress, measure improvement, demonstrate value, effectiveness and benefit and provide evidence of return on investment, all sites participating in the national CR project are required to collect data using a number relevant process and outcome measures.
View/download the final version of the measures for the project.
Hospital Episode Statistics (HES) data on Readmissions 2008/09 Extract
Following discussion at the second national CR project meeting on 13/1/11, the national team agreed to provide a more direct link to the HES data on cardiac readmissions included in the costing tool section of the CR commissioning pack. This data can be used by project teams to provide a baseline for the measure on readmissions.
View the HES data contained within the costing tool.
Please note that this data is from the 2008/09 extract. Other important assumptions and caveats can be found in the ‘Calcs’ section of the costing tool in the commissioning pack
We are currently working with the Department of Health to refresh the spreadsheet with 2009/10 data.
Bringing Lean to life
Referred to at the second national CR project meeting on 13 January 2011 (following the presentation on the RPIW by Sue Collins), the new booklet produced by NHS Improvement’s diagnostics team, Bringing Lean to Life, provides a basic introduction and overview of Lean; the culture, principles and tools to understand, tackle and resolve issues within healthcare. Please note that it is not intended as a complete guide to implementing Lean as a management system.
National cardiac rehabilitation projects 2009/10
Launched in September 2008, the national priority project for cardiac rehabilitation selected nine projects, comprising 12 NHS sites from across the country supported by the cardiac and stroke networks, to drive forward improvements in cardiac rehabilitation services.
The overall aim of the national project was to increase access to, equity of provision for, and uptake of CR services for patients having heart attack and/ or revascularisation, in line with the National Service Framework for CHD. In doing so, the project sought to pilot implementation of the NICE recommendations on cardiac rehabilitation- as outlined in the NICE Clinical Guidelines on MI: Secondary prevention (NICE CG48, 2007)- utilising the subsequent NICE commissioning guide for CR services (2008). Co-ordinated by Linda Binder, National Improvement Lead for NHS Improvement, and supported by Professor Patrick Doherty, BACR chairperson and National Clinical Lead, and Dr Jane Flint, consultant cardiologist and National Clinical Advisor, the National Project invited applications which focused on:
- Identification and active engagement of eligible CR participants using a systematic and structured approach
- Development of mixed models of provision tailored to meet the needs of individual patients
- Relevant rehabilitation for groups less likely to access the service such as women or ethnic minorities
- Development of exercise components designed to meet the needs of older people or those with significant co morbidities
- Joint agreement, planning and commissioning of services across hospital trust, GP practice, PCT and social/leisure services and at network wide level
- Exploration of the feasibility of a generic rehabilitation model encompassing other disease modalities.
The Project was also keen to ensure that the following core issues were addressed:
- Reducing inequalities
- Increasing access to and information about CR services
- Engaging patients/carers/families in planning services
- Workforce and multi-disciplinary team approaches.
Published twelve months after the commencement of the Project in October 2009, the interim report on the Cardiac Rehabilitation National Priority Project: Lessons and Learning One Year On effectively summarised the key learning from across all the sites and aimed to share the initial outputs, outcomes and improvements with a wider audience.
Download the 'Lessons and Learning - One Year On' report.