Digital Healthcare and Medtech News

Jane Stokes

Jane Stokes

27 Apr, 2021

How to Achieve the 2028 NHS England Long-Term Plan Targets for Cardiac Rehab.

Dorset County Hospital NHS Foundation Trust Cardiac Rehabilitation team have hit the 2028 NHS targets for the past two years by adopting a new approach utilising the my mhealth app, myHeart.

myHeart iPad App
Digitally enhanced cardiac rehabilitation in the myHeart app

Cardiac Rehabilitation (CR) is one of the most clinically and cost-effective therapeutic interventions in cardiovascular disease management, reducing mortality and hospital admissions, whilst improving functional capacity and quality of life (1). The average number of patients who agree to be referred to CR in England is 50%, of whom 76% will go on to complete a programme (2). There are many reasons why people don’t take up the offer, but one key factor is accessibility. NHS England has set a target for services to achieve an 85% uptake to Cardiac Rehabilitation by 2028 (3). To work towards that target the BACPR are calling for clinical services to review alternative modes of delivery, that maintain quality standards, and patient outcomes whilst providing greater flexibility (4).

One cardiac rehabilitation service in Dorset has been ahead of the game and first introduced a menu-based approach to CR delivery back in 2004 to try to improve their uptake figures from 50%. The model incorporated traditional programme delivery as well as remote delivery options for those unable to attend face-to-face sessions. By 2016-17 the team were achieving uptake of 70% using this new approach. However, the team "felt that there was an unmet need, particularly for those who felt too vulnerable to travel to a cardiac rehab group or couldn’t attend a day-time session due to work or care-giving responsibilities."

myheart iPhone App
The myHeart app is available on any device

In 2017 the team began working with my mhealth to develop a new cardiac rehabilitation module within their myHeart App to support a digital element to service delivery that compliments both the traditional and remote models of delivery. The impact of utilising myHeart on CR uptake can be seen in the table below, with the services far exceeding the NHSE targets for 2028:

2019/2020
Mode of Delivery Quarter 1 Quarter 2 Quarter 3 Quarter 4
Home Based 31 22 31 26
myHeart Remote 16 26 24 58
Traditional 75 82 76 61
Uptake for patients referred 95% 100% 100% 100%

In March 2020 all face to face cardiac rehabilitation classes were suspended due to Covid-19 as patients with a pre-existing cardiovascular disease were deemed to be at increased risk of more severe complications. For services without alternative modes of delivery, service provision was suspended and there was a rapid demand to quickly identify and adopt alternative modes of delivery to continue to support patients. However, the team in Dorset, due to the increased flexibility and resilience of their service model, simply suspended their traditional delivery and moved patients on to one of their other options.

The results on patient uptake can be seen below:

2020/2021
Mode of Delivery Quarter 1 Quarter 2 Quarter 3 Quarter 4
Home Based 45 42 90 56
myHeart Remote 67 64 73 43
Traditional 0 2 3 0
Uptake for patients referred 84% 95% 100% 100%

Cardiac Rehab Specialist Nurse Shaun Porter told us...

The menu-based approach of cardiac rehabilitation, has allowed us to provide an individually appropriate cardiac rehabilitation service to all of our patients, irrespective of physical conditions, ability to travel, IT literacy or socio-economic status. This, coupled with our holistic cardiac event follow-up clinic, ensures that all patients are assessed and treated promptly and holistically following their cardiac event.

The digitally enhanced approach adopted in Dorset has increased uptake to Cardiac Rehabilitation to consistently achieve and surpass the NHS targets for 2028 and increase service resilience.

‘The myHeart App has proved really popular with patients and complements the other group-based and individual treatment options the rehab team offer. More cardiac patients than ever before are now receiving some form of rehab thanks to developments such as myHeart, which is having a hugely positive impact on people’s recovery and quality of life.’

If you want to find out more about how digitally enhanced cardiac rehab can help you meet the NHS England Long-Term Targets for cardiac rehab please get in touch here or call us on +44 (0)1202 299 583.


Topics

NHS England Long-Term Plan Cardiac Rehab Digitally enhanced rehab myHeart app digital health

Further information

Email: info@mymhealth.com
Call: +44 (0)1202 299 583


References

1. National Institute for Health and Care Excellence (2013) Myocardial infarction: cardiac rehabilitation and prevention of further cardiovascular disease.

2. Audit of Cardiac Rehabilitation (2019) Quality and Outcomes Report.

3. NHS England (2019) Long Term Plan: Cardiovascular Disease.

4. BACPR (2017) The BACPR standards & Core Components for cardiovascular disease prevention and rehabilitation, BACPR, 3rd Edition.


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