Home-based cardiac rehabilitation training offered free to cardiac teams affected by COVID-19

The Rehabilitation Enablement in CHronic Heart Failure (REACH-HF), a 12-week, evidence-based home-based cardiac rehabilitation programme was developed to help increase participation in rehabilitation therapies for heart failure patients and carers by bringing care into their own homes.

Researchers at the Universities of Exeter, Birmingham, and York and the Royal Cornwall Hospitals NHS Trust, in collaboration with the Heart Manual Department, NHS Lothian, brought together clinicians, academics, patients and caregivers to produce a suite of resources, including self-care education, a choice of exercise programmes and psychological support.

A study into the effects of the home-based cardiac rehabilitation programme showed that it can produce important improvements in health-related quality of life for participants and is also cost-effective for the NHS. The researchers behind REACH-HF are now hoping the programme can also deliver benefits for heart failure patients confined to their homes because of the coronavirus pandemic.

All cardiac rehabilitation programmes across the country are being asked to support the NHS by refraining from inviting patients to attend hospitals and clinics for group-based sessions, and, where appropriate, diverting key members of their teams to COVID-19 related tasks. Nearly 200,000 people are diagnosed with heart failure in the UK each year. Exercise-based rehabilitation and self-care support are key to recovery, but many patients cannot now access rehabilitation services because of the widespread impact of COVID-19 on provision of some health care services.

The REACH-HF study team, in collaboration with NHS Lothian’s Heart Manual Department and Health and Care Innovations, are playing its part in supporting the NHS and heart failure patients by offering free REACH-HF programme delivery training sessions to NHS staff over the summer.

Courses have been set up over the next few weeks to train approximately 20 cardiac rehabilitation teams and further sessions are planned for later in the year. The aim is to have 30 sites, including between 30-60 delivery staff, trained by the end of September. This is in addition to eight cardiac rehabilitation teams in England and Northern Ireland who are already trained to deliver REACH-HF.

Professor Colin Greaves, of the School of Sport, Exercise and Rehabilitation Sciences at the University of Birmingham, led the intervention development team for REACH-HF. He said: “REACH-HF provides an opportunity for cardiac rehabilitation and health professional support to be delivered to the patient at home and supported over the phone, without any need for face-to-face contact. Home-based rehabilitation could be a really useful option during the current lockdown.”

“Our approach enables health care workers to support patients while maintaining vital social distancing and also maximising effective use of available resources.”

The co-leads of the REACH-HF programme are Dr Hasnain Dalal (University of Exeter and the Royal Cornwall Hospitals NHS Trust) and Professor Rod Taylor (MRC/CSO Social and Public Health Sciences Unit, University of Glasgow). Dr Dalal said: “If patients can’t access rehabilitation then their risk of relapse and death is higher – mortality is 12 % higher in those not referred for rehabilitation. We already know that REACH-HF is successful in helping people with heart failure enjoy a better quality of life. We’re now offering training for this programme for free to help save lives during the COVID-19 crisis.”

The REACH-HF team have also recently been shortlisted for a BMJ Award in the Stroke and Cardiovascular Team category.