Cardiac rehabilitation proven to significantly reduce illness, hospital admissions and death

• Patients with poor heart health have access to timely high quality cardiac rehabilitation care in their own communities
• New ways of working will help patients to live well at home with chronic cardiovascular disease

The HSE is launching new developments in cardiac rehabilitation, designed to save lives and significantly improve the quality of life for many thousands of patients with cardiovascular disease, while also treating people close to home.

Cardiac rehabilitation starts in hospital when a patient is admitted with an emergency cardiovascular event such as a heart attack or heart failure and is a process that continues for the patient upon discharge into the community and at home. It is a supervised programme designed to improve a patient’s cardiovascular health and to empower them with the knowledge and tools to manage their cardiovascular disease and to live well with their chronic condition. It includes education on risk factor management, heart healthy living and exercise, counselling and training. It is offered to people who have experienced a heart attack, angioplasty and heart surgery and to people with heart failure.

For people who have been hospitalised with cardiovascular disease, keeping well and preventing repeat events and hospitalisations is paramount. Cardiac rehabilitation has consistently been demonstrated to significantly reduce illness, hospital admissions and death amongst patients with established cardiovascular disease, while also increasing their quality of life. Access to cardiac rehabilitation will be significantly improved (currently 40% of eligible patients are waiting for at least three months) due to the significant additional resources that the HSE has funded to support increased patient choice in where and how they participate in cardiac rehabilitation.

This service is based on the Model of Care for Integrated Cardiac Rehabilitation and it is a major step forward. It will ensure that patients living with cardiovascular disease across the country have access to timely, high quality cardiac rehabilitation care, no matter where they live. It is an evidenced-based and cost-effective approach that helps patients to manage their own condition in partnership with their healthcare professionals. It has consistently been demonstrated to significantly reduce morbidity, hospitalisations and mortality among patients with established cardiovascular disease while also increasing their quality of life.

The model also places a focus on encouraging and supporting referral to, and attendance at, cardiac rehabilitation for those who are traditionally under-referred to cardiac rehabilitation, such as women, older patients and marginalised groups.

The Model of Care was developed by the Prevention Sub-Group of the Clinical Advisory Group of the National Heart Programme in partnership with key stakeholders. Reflecting the Sláintecare vision, the model recommends the integration of cardiac rehabilitation services across hospital and community settings to provide person-centred care by a multidisciplinary team of nursing, health and social care professionals, medical and administration staff.

Implementation of the Model is supported by the National Heart Programme, Integrated Care Programme for Chronic Disease and the Enhanced Community Care (ECC) Programme. Through ECC and Modernised Care Pathways patients are being treated for their chronic heart disease closer to home. This is proving life changing for those now availing of such community based services.

Ann Keady from Newcastle in Galway had a heart attack in October 2022. She says:

“I had a stent put in and spent a few days in University Hospital Galway.  When I came back out of hospital that’s when things kind of hit me mentally and physically. So when I heard about rehab I was a bit apprehensive about it, you don’t know who you are going to meet there, being from Galway, but I’m certainly delighted I came to rehab. It’s given me hope, it’s given me a feeling I can get back to what I was.’’

Dr Sarah O’Brien, HSE National Clinical Advisor and Group Lead for Chronic Disease said:

“Cardiac rehabilitation is an evidence-based and cost-effective treatment that helps patients manage their condition in partnership with their healthcare professionals. This Model of Care outlines the best practice care and services for people requiring cardiac rehabilitation. It will support healthcare professionals to deliver a timely, high quality, equitable, person-centred, and evidence-based service and also inform patients and their families as to what they can expect from their cardiac rehabilitation service.”

Professor J William McEvoy, Chair of the Prevention Sub-Group of the National Heart Programme and Director of the National Institute for Prevention and Cardiovascular Health said:

“The Model of Care for Integrated Cardiac Rehabilitation represents the culmination of years of hard work. It will support the provision of optimal care for patients living with chronic cardiovascular disease in Ireland. This model of care has been developed and refined by a wide range of stakeholders within the Irish healthcare system. I acknowledge the work of all involved to make this Model of Care available for patient care. In addition, as an internationally active researcher in preventive cardiology, I can confidently say that this Model of Care incorporates the latest and best in evidence-based medicine. I see the publication as a further advance in improving timely access to and consistency of care for patients who require cardiac rehabilitation across the country.”

Professor Ken McDonald, HSE Clinical Lead, National Heart Programme said: “The Model sets out a robust cardiac rehabilitation service as part of an integrated framework for the prevention and management of chronic disease in Ireland, placing patients squarely at the centre of care. The cardiac rehabilitation service will be planned around patients according to need; so as to support and empower them to optimise their health, actively address and minimise their risk factors for chronic disease, and to live well with chronic disease. The National Heart Programme endeavours to support cardiac rehabilitation professionals, as we work together to implement this.”

Dr Colm Henry, Chief Clinical Officer, HSE added:

“I greatly welcome this Model of Care for Integrated Cardiac Rehabilitation, which was developed by a multi-disciplinary group, led by Professor William McEvoy and supported by the HSE National Heart Programme and Integrated Care Programme for Chronic Disease. The development of this is a major step forward in that it will ensure that eligible patients across the country receive standardised care, in a timely manner and based on the best available evidence. I would like to acknowledge the work of all involved to make this Model of Care available for patient care to further improve the management of chronic cardiovascular disease in Ireland."

Dr Angie Brown, Medical Director, Irish Heart Foundation said:

“The Irish Heart Foundation whole-heartedly welcomes the Model of Care for Integrated Cardiac Rehabilitation, as it is an essential component of secondary prevention of cardiovascular disease. We know from supporting and advocating for patients living with cardiovascular disease and their families that these patients need ready access to cardiac rehabilitation. This Model of Care will support healthcare professionals to provide this service and provide a mandate to fund and equip cardiac rehabilitation centres. This will have a significant impact in saving lives and improving the quality of life of large numbers of cardiac patients all over Ireland.”

Model of Care for Integrated Cardiac Rehabilitation (PDF, 1.5 MB, 112 pages)