Cardiac Rehabilitation is offered to anybody who has undergone cardiac surgery and/or has had a heart attack. The team helps to rehabilitate you, that is, improve your recovery through advice, support, and exercise.

Cardiac Rehabilitation is divided into four phases:

• Phase 1 is the inpatient stage and includes medical evaluation, reassurance and education, risk factor assessment, mobility and discharge planning. If you are admitted to Hereford County Hospital one of the Cardiac Rehabilitation team will see you to discuss your concerns, any mistaken beliefs and how to manage your problem actively. This also occurs if you attend for an angiography.
• Phase 2 is the immediate post-discharge phase and normally lasts between 4-6 weeks. Sometimes this period at home may be a little frightening for patients after being under close supervision while in hospital. The role of Cardiac Rehabilitation here is to act as a support for the patients and their families to help them to gradually resume normal activities. This support takes the form of telephone calls and organising for patients to be seen in the hospital or at one of our community venues by one of the team.
• Phase 3 is traditionally the phase where structured exercise is introduced, alongside relaxation training and education around controllable risk factor management.
• Phase 4 is when the patient leaves the Cardiac Rehabilitation team and joins one of our accredited community exercise programmes. These are run by Hereford and Leominster Cardiac Support Groups and by LIFT (Lifestyles Improvements for Today) a Council-run scheme. All exercise groups are run by Fitness Instructors qualified to take cardiac patients.
• The Cardiac Rehabilitation team also holds pre-surgery evenings for those who will be having planned surgery. These are designed to give people as much information as possible leading up to their operation and maximise their recovery post-operatively. These sessions are held approximately every six weeks in the Therapy Services Gym of the County Hospital, Hereford, between 6.30pm – 8.00pm. Relatives are encouraged to attend with those going for surgery.

Herefordshire Cardiac Rehabilitation offers a package of care choices at Phase 3, the active rehab stage of your recovery.

• Group-based Rehabilitation – is involves joining others in exercise, relaxation training and education sessions over an 8-week period. These group sessions are held at Hereford County Hospital, the Ryefields Centre in Ross-On-Wye and at the Bridge St Sports Centre in Leominster. The sessions involve participation in an exercise session to help strengthen your heart, relaxation training and then an education session on how to optimise your recovery and management of heart disease.
• The British Heart Foundations ‘Road to Recovery’ Home-based programme – this is a home-based cardiac rehab package supported by a diary, exercise video/DVD and a relaxation tape/CD. The Cardiac Rehabilitation team assesses you in the first instance and, once you have passed, you may be put on this programme for a 6-week period. Support is maintained through a weekly telephone call and final discharge meeting.
• Walking Programme – our walk programme supplements both the above but can also be used by patients as the main part of their rehabilitation. Again support for this programme is on a weekly basis over a 6-week period.
• Educational Support – sometimes patients do not or cannot be involved with the exercise component of Cardiac Rehabilitation. In these circumstances they are still able to come along to Relaxation and/or the educational part of the course. Written information is also available from the British Heart Foundation.
• Stress Management and Individual Support – Relaxation Training is offered as part of the group programme. However the team is also able to offer individual stress management advice if required. A referral to Counselling Services can also be organised.
• Signposting – the last service the Cardiac Rehabilitation team offers is signposting to other services – smoking cessation, dietetics etc… if patients want to access these services, the team will help them do that.

After completion of Cardiac Rehabilitation you are given the option of joining the LIFT scheme at one of the local leisure centres. These are run by exercise instructors who are members of the British Association of Cardiac Rehabilitation (BACR). This is known as Phase 4 Cardiac Rehabilitation.

You can also become a member of one of our local Cardiac Support Groups based in Hereford or Leominster. Again, these groups hold regular exercise classes with a BACR exercise instructor as well as undertaking other social activities like led walks in the countryside. Many find these groups a great support learning to live with chronic heart disease.

As well as caring for patients recovering from heart disease, the Cardiac Rehabilitation Department regularly undertakes public health events to highlight the dangers of heart disease and how to try to avoid the risks of developing it.

They promote a healthy lifestyle message which includes the following advice:

• Engage in an active lifestyle – including regular walking and other heart and lung exercise
• Eat a good balanced diet – try to limit saturated fats, salt and alcohol intake, whilst ensuring you eat plenty of fruit, vegetables, fibre and keep hydrated. Also try to eat up to 3 portions of oily fish each week
• Manage stress – ensure you find time to enjoy yourself and relax
• Try to stop smoking, or cut down in the first instance
• If difficulty is experienced making a positive health behaviour change, support should be sought.

The Cardiac Rehabilitation team is supported by the British Heart Foundation and work very closely with other agencies in the County such as LIFT, DiabetesUK, Herefordshire Primary Care Trusts’ Expert Patient Programme and BHF HeartStart UK, to ensure patients get the best care and support possible.

Do I need a referral?

Anyone who has had a heart operation (angioplasty, bypass surgery and valve surgery) is eligible to attend. Often, referral is made directly by the hospital where the operation took place and, within a few days of returning home, one of the Cardiac Rehabilitation team will contact you by telephone. Certainly if you did not hear from us within a week of discharge you should make contact to make the necessary arrangements to join one of our programmes. Our telephone/fax number is 01432 364206.