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 do not take up the offer, but one key factor is accessibility. NHS England has set a target for CR services to achieve an 85% uptake by 2028 (3). In support of achieving this target the British Association for Cardiovascular Prevention and Rehabilitation (BACPR) are calling for clinical services to consider alternative modes of delivery that maintain quality standards and patient outcomes, whilst providing greater flexibility (4).

In 2004, the Dorset CR service first introduced a menu-based CR delivery model which provided patients with a choice of either traditional in-person or home-based CR programmes. By 2016-17 the team had achieved a 20% increase in patient participation equating to a 70% annual patient uptake. However, the team "felt that there was still an unmet need, particularly for those who felt too vulnerable to travel to a CR group or could not accommodate a CR session during the day due to work or care-giving responsibilities."

myheart iPhone App — The myHeart app is available on any device

In 2017, the Dorset CR team and my mhealth developed an innovative CR module within myHeart to offer patients a digital component to compliment both traditional in-person and home-based models of CR delivery. The impact of utilising myHeart for CR uptake can be seen in the table below, with the services already exceeding the NHSE targets for 2028:

	Year 1: Mar 2019 - Apr 2020	Year 2: Apr 2020 – Mar 2021	Year 3: Apr 2021 – Jun 2021 (ongoing)
Total Patients Referred for CR	518	524	148
Total Patients Completed CR	463 (89.3%)	484 (92.4%)	145 (98%)
Total Patients who completed CR by mode of delivery	Patient Numbers
Home-based CR	79	208	74
Digital CR - myHeart	90	214	47
In-person group-based CR (Phase 3)	230	6	2
Combined (home-based, digital - myHeart, in-person group-based)	64	56	22

In March 2020, most traditional in-person CR programmes were suspended due to Covid-19. There was a rapid demand to quickly identify and adopt alternative ways of delivering CR to patients. However, the team in Dorset, due to the increased flexibility and resilience of their service model, simply suspended traditional in-person CR delivery and offered patients one of the other available options. myHeart usage increased by 124 (23.7%) patients during the first Covid-19 wave and continues to be a popular option for patients with a further 32.4% opting to use it in the first three months of year 3. These results show that digital health can contribute to supporting CR services to achieve greater patient uptake and completion rates.

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