Associate feature: Cardiac rehab during a pandemic

Every day in Scotland more than 30 people have a heart attack. This doesn’t stop for a pandemic.  

The road to recovery can take time and it is important that the right measures are in place for support. Research has shown that cardiac rehabilitation – or cardiac rehab as it’s known - can reduce the risk of further cardiac events, being readmitted to hospital and has a positive impact on wellbeing and quality of life.

Usually offered after an assessment following a cardiac event such as a heart attack, heart surgery or after diagnosis of some other heart conditions, traditional rehab provides information, support and advice and is also is designed to help patients understand and come to terms with what has happened.

Most cardiac rehab is delivered face to face, however, given the unprecedented times that we’re now living in as we tackle the threat posed by COVID-19, this is not a viable option. Social distancing rules and the redeployment of cardiac rehabilitation teams to support the COVID response, has meant services have had to be creative, resilient and innovative about how they can provide the right support to patients at this time. 

We're making it easier for people to have access to the support they need

Many people may now be discharged from hospital with no assessment, reduced or even no cardiac rehab input and limited advice about what they should be doing when they get home. NHS cardiac clinical leads quickly expressed major concerns to us that patients being discharged without access to this life changing support programme, could be readmitted with health concerns. 

Ensuring that people with heart and circulatory conditions continued to receive the support that they need is our primary focus and so immediately, it became apparent to us that we needed to join forces with NHS boards - and fast - to devise and deliver adaptable programmes to aid patients’ recovery.

And so, we swung into action. We contacted our partners in the clinical community and within three days set up and delivered a webinar to discuss and share information on how we could continue to support our patients. Such was the overwhelming interest from the medical profession in Scotland and across the UK, that more than 150 clinicians subscribed to take part.

Remarkably, just one week later and following a huge amount of work, the first stage of our Cardiac Rehab at Home programme was launched on our website – a true testament to the amazing efforts of the clinical community and our teams within the BHF to react, collaborate and step up at such a critical time in all our lives and provide an urgent response to an urgent situation.

Our initial offering has involved us making our popular cardiac rehab DVD - “My Personal Trainer” – available online, accompanied by a step-by-step guide. The video, which is free to download, features low level to moderate intensity exercises similar to those undertaken in a cardiac rehab class, but that are easy to do in the home.  They come in 5 stages tailored to different patient needs and are designed for those who have already had an assessment. The programme also aims to replicate the four pillars of the cardiac rehab experience by supplying the exercises, emotional support, healthy eating information and additional information all via one hub on our website.

Of course, for some, cardiac rehab can be a way of connecting with others going through similar experiences, a connection which is at risk of being lost during these times of isolation. And so alongside our online offerings, patients can be signposted to BHF peer to peer support groups, helping people reach out during these times, and to our Heart Helpline.

Early indications have shown an extremely positive response from both the patient and clinical community to our adapted cardiac rehab programme. From a sample of over 800 users of the online resources, 91% of people were able to find the information they were looking for and 87% said that the information they found made them more confident to do rehabilitation at home.

Clinicians have been in touch with us to say, “This is great. I have sent it out to all of our rehab team to start using now”, “Thank you BHF for this resource” and “The webinar and resources have been so helpful throughout this challenging time”.

It is true that we are living in uncertain times and as a charity, the British Heart Foundation is not immune to the challenges that lie ahead. This crisis is having a huge impact on our work. Our shops have closed and scores of fundraising events– which support our life-saving research – have been cancelled.   We estimate that we will lose £10m a month in funds that we need to deliver our work whilst the current operating environment remains.

But our commitment to support the estimated 720,000 people in Scotland living with heart and circulatory diseases is unwavering. And we hope our swift actions in delivering the first stage of our Cardiac Rehab at Home programme are proof of that and of the high quality information the BHF provides.

Alongside this, we have taken further steps to help patients and their families in these challenging times. In response to receiving more than double the usual number of calls and emails to our specialist nurses on our Heart Helpline, we’ve expanded our service. We're making it easier for people to have access to the support they need – whether practical, or emotional - by extending our opening hours. This will also help our nurses better manage the volume of calls we are receiving.

What's more, we understand people want access to accurate and relevant resources for their individual circumstances. Whether they need answers about being classified as at increased risk from coronavirus, seek tips for keeping active, or want to access our online cardiac rehabilitation resources, we've done our very best to cover all bases on our BHF website.

As the COVID-19 outbreak continues, we will carry on supporting those who need and rely on our support. We will continue to listen to our community and provide resources on topics and issues that reflect what people need now and in the future. More cardiac rehab resources will be rolled out over the coming weeks and months and we will be updating the programme regularly online with new content on healthy eating and activity. And together we will work with our partners across the clinical community to beat heartbreak forever.

You can find more details on our Cardiac Rehab at Home programme at our website - https://www.bhf.org.uk/informationsupport/support/cardiac-rehabilitation-at-home

For the latest information and support for people living with heart and circulatory diseases at this time, visit www.bhf.org.uk/coronavirus

Richard Forsyth, Health Services Engagement Lead, BHF Scotland