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Original research article
Does cardiac rehabilitation meet minimum standards: an observational study using UK national audit?
  1. Patrick Doherty1,
  2. Ahmad Salman1,
  3. Gill Furze2,
  4. Hasnain M Dalal3 and
  5. Alexander Harrison1
  1. 1Department of Health Sciences, University of York, York, North Yorkshire, UK
  2. 2Centre for Technology Enabled Health Research, Coventry University, Coventry, West Midlands, UK
  3. 3University of Exeter Medical School (Truro Campus), Knowledge Spa, Royal Cornwall, Truro, UK
  1. Correspondence to Professor Patrick Doherty; patrick.doherty{at}york.ac.uk

Abstract

Objective To assess the extent by which programmes meet national minimum standards for the delivery of cardiac rehabilitation (CR) as part of the National Certification Programme for Cardiovascular Rehabilitation (NCP_CR).

Methods The analysis used UK National Audit of Cardiac Rehabilitation (NACR) data extracted and validated for the period 2013–2014 set against six NCP_CR measures deemed as important for the delivery of high-quality CR programmes. Each programme that achieved a single minimum standard was given a score of 1. The range of the scoring for meeting the minimum standards is between 1 and 6. The performance of CR programmes was categorised into three groups: high (score of 5–6), middle (scores of 3–4) and low (scores of 1–2). If a programme did not meet any of the six criteria, they were considered to have failed.

Results Data from 170 CR programmes revealed statistically significant differences among UK CR programmes. The principal findings were that, based on NCP_CR criteria, 30.6% were assessed as high performance with 45.9% as mid-level performance programmes, 18.2% were in the lower-level and 5.3% failed to meet any of the minimum criteria.

Conclusions This study shows that high levels of performance is achievable in the era of modern cardiology and that many CR programmes are close to meeting high performance standards. However, substantial variation, below the recommended minimum standards, exists throughout the UK. National certification should be seen as a positive step to ensure that patients, irrespective of where they live, are accessing quality services.

  • CORONARY ARTERY DISEASE

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Footnotes

  • Twitter Follow National Audit of Cardiac Rehab @NACR_Audit

  • Contributors PD and AS are responsible for conception acquisition, analysis, interpretation of data for the work, drafting the work and revising critically for important intellectual content and approved the final version of the manuscript to be published and agreed to be accountable for errors. GF, HMD and AH are responsible for conception acquisition, interpretation of data for the work, drafting the work and revising critically for important intellectual content, approved the final version of the manuscript to be published and agreed to be accountable for errors.

  • Funding This research was carried out by the British Heart Foundation (BHF) Cardiovascular Care and Education Research Group which is supported by a grant from the BHF (R1680901).

  • Competing interests None declared.

  • Ethics approval Health and Social Care Information Centre.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.