Cardiac rehabilitation: integrating primary and secondary care

The provision and funding for cardiac rehabilitation in the UK are inconsistent. Services are mainly hospital-based and are, therefore, inaccessible to many who would benefit from them. This article summarizes the nursing response of one acute hospital trust in trying to expand the cardiac rehabilitation program, integrate services with primary care and increase patients' access to services.

The approach taken focused upon developing primary care services and integrating these with the provision already established in the hospital. The project comprised five stages: training, protocol development, referral pilot project, evaluation and expansion. The work was underpinned, by principles of communication, consultation and collaboration.

Key points from the evaluation are presented and problems identified. Benefits of the project include improvements in communication between hospital and community staff and within the practice, and increased access to information and support for people to promote recovery.

It is suggested here that, financially and professionally, the future of cardiac rehabilitation services lies in primary care. This collaboration provides one approach to blend primary care services with those provided in secondary care.