New cardiac rehab model of care aims to address service deficits

Heart and stroke patients and carers welcome new model

Max Ryan

November 27, 2023

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  • The HSE has launched a new Model of Care for Integrated Cardiac Rehabilitation aimed at improving services.

    This is the first standardised model of care for cardiac rehabilitation services across the country.

    Heart and Stroke Voice Ireland (HSVI), a new alliance of heart and stroke patients and carers, has welcomed the new model.

    The Model of Care document stresses that despite the robust evidence base for cardiac rehabilitation, ensuring equitable and timely access to this service for all eligible patients living in Ireland has been challenging.

    It says to address this challenge, the Enhanced Community Care Programme has provided significant additional resources to uplift existing hospital-based cardiac rehabilitiation services. 

    “However, it is clear that beyond additional resourcing, action is also required to support recruitment and retention of patients who are likely to benefit from cardiac rehabilitation to support the optimisation of patient outcomes.”

    The document focuses on early inpatient contact, automatic referral to cardiac rehabilitation services, early and standardised initial assessment and a standardised set of components to be delivered in all cardiac rehabilitation services.

    These components include initial assessment and development of a person-centred plan, health behaviour change, education, lifestyle and medical risk factor management, as well as an end-of-programme assessment.

    The Model of Care provides for each cardiac rehabilitation service collecting, reviewing and acting on data as part of a systematic quality improvement programme. 

    For healthcare professionals, the Model of Care sets out seven key steps that must be attended to in order to deliver a high-quality, integrated cardiac rehabilitation service across hospital and community settings.

    These include early patient contact with a service, supporting patient choice and engagement, structured phone calls or home visits, a patient-centred care plan, end-of-programme assessment/discharge and service evaluation.

    The Model of Care also recommends the establishment of new governance structures across all hospital and community cardiac rehabilitation centres.

    David Kelly, chair of HSVI, welcomed the new Model of Care. He said: “HSVI was established to give a unified voice to heart patients, stroke survivors and their carers, and to advocate for a patient-centred model of care, and more equitable access to rehabilitation services, both of which are core elements of this new strategy.”

    Mr Kelly added that this new HSE model will introduce a standardised model of care that ensures all cardiovascular patients across the country are afforded equal access to the highest international standards of cardiac rehabilitation.

    For more details, see

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