Gaps in cardiac rehab place burden on GPs
By Danusia Osiowy
Provision of cardiac rehabilitation is falling far short of national targets, leaving GPs to shoulder the burden of managing patients' recovery, a national audit reveals.
No area of England came anywhere close to meeting the Government's target to provide rehabilitation to 85 per cent of eligible patients.
The audit, presented at the World Congress of Cardiology in Barcelona last week, also revealed stark variations in care. The proportion receiving rehabilitation after hospital discharge ranged from 40 per cent in the North West and North East down to 15 per cent in the East Midlands.
Attendance differed according to clinical condition, with only 27 per cent of those who had suffered a heart attack receiving rehabilitation, against 66 per cent of those who had had a coronary artery bypass.
Study leader Professor Bob Lewin, professor of rehabilitation at the University of York, said the figures highlighted a 'postcode lottery' in services.
'The burden will fall on GPs as they have to cope with the anxiety, depression and invalidism that patients show after a cardiovascular event,' he said.
The importance of providing cardiac rehabilitation is highlighted by a Cochrane review that found it reduced cardiac mortality by 26 per cent at two to five years.
Dr Rubin Minhas, a member of the Primary Care Cardiovascular Society and a GP in Gillingham, Kent, said: 'The importance of cardiac rehab is
under-recognised because the QOF and guidelines such as the JBS mainly emphasise targets for prescribing drugs. I am sure GPs would welcome wider access to services, which would also relieve pressure on practices.'
A Department of Health spokesperson said there had been significant progress in providing better services but added: 'We know there is still more to do and have been focusing more attention on secondary prevention.
'The Heart Improvement Programme has been working to increase rehabilitation uptake by developing local action plans.'