South Wales Cardiac Network Cardiac Rehabilitation Advisory Group Meeting - PowerPoint PPT Presentation

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South Wales Cardiac Network Cardiac Rehabilitation Advisory Group Meeting

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South Wales Cardiac Network Cardiac Rehabilitation Advisory Group Meeting Wednesday 16th February 2011 Glynclydach Hotel, Longford Road, Dyffryn, Neath, SA10 7AJ – PowerPoint PPT presentation

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Title: South Wales Cardiac Network Cardiac Rehabilitation Advisory Group Meeting


1

South Wales Cardiac NetworkCardiac
Rehabilitation Advisory Group Meeting Wednesday
16th February 2011 Glynclydach Hotel, Longford
Road, Dyffryn, Neath, SA10 7AJ
2
BACKGROUND TO SERVICE
  • HISTORY OF CARDIAC REHABILITATION SERVICE
  • SOUTH POWYS
  • BRECONSHIRE WAR MEMORIAL HOSPITAL
  • 1998 - Part-Time ward Nurse established basic
    Cardiac Rehabilitation Programme with Support
    from Hospital Physiotherapist and G. P.
  • 2000 - Full-Time G Grade Nurse and Part-time E
    Grade Nurse providing all 4 Phases of Cardiac
    Rehabilitation in Brecon
  • E Grade nurse upgraded to F Grade. Now
    working four
  • days a week.
  • Implementation of the NSF for CHD commences in
    Powys.
  • 2003 G Grade upgraded to H Grade Clinical
    Nurse Specialist for Coronary Heart
    Disease/Cardiac Rehabilitation.
  • Appointment of Second F Grade full-time Nurse.
  • March 2003 All 4 phases of Cardiac Rehabilitation
    provided for patients in the Ystradgynlais area.
  • 2006 CHD full time appointed for North Powys
  • June 2006 Cardiology Clinics commenced.

3
BACKGROUND CONTD
  • 2006 H grade leaves service not replaced.
  • Cardiac Rehab moves into Leisure centre, lose
    Physio, and OT input
  • May 2007 BHF Heart Failure Nurse
  • Sept 2009 Ystradgynlais CHD Nurse leaves not
    replaced Helen to Cover South Powys Dean
    North
  • 2010 BHF funding expires not continued
  • 2011 one vacate post to cover Mid Powys
  • One CHD Nurse South one North

4
Phase 1
  • Not provided in Powys

5
Phase 2
  • Telephone contact and offer a home visit
  • Support and reassurance
  • Education and advice
  • Encouragement and Motivation
  • Symptom recognition
  • Heart Manual Use of home based programme if
    appropriate
  • Total referrals 230

6
Phase 3
  • 8 week individualised programme provided by CHD
    Nurse and BACR Instructor
  • Brecon, Ystradgynlais, Newtown
  • Education, exercise and stress management
  • Assessments Psychological measures (HAD),
    physical ( 6 min . Walk test) perceived fitness
    and risk factors.

7
Phase 4
  • Inform primary care
  • Professional monitoring of clinical status
  • Encouragement with lifestyle changes
  • Community classes Healthy Heart Programme -
    NERs
  • Social Support
  • Ongoing education

8
Skill Mix
  • 1x 30 hours (0.8 WTE) cover South Powys
  • 1x 37.5m hours (1 WTE) cover North Powys
  • BACR instructors cover exercise component of the
    rehab programme
  • Recent Occupational Therapy commitment

9
Significant Challenges / Successes
  • Reorganisation, restructuring, recovery planning
    and current financial situation - Current funding
    secure but difficulties with new developments
  • Processes for vacancies mean slow progress
  • Partnership working is both a success and a
    challenge
  • Sustainability of service with 2x1.8WTE nurses,
    however successfully delivering current services
    across Powys
  • BHF support
  • SuSuds

10
Current Challenges
  • Role change Generic cardiac Nurses
  • Management structure
  • No cover for sickness/ annual leave
  • Locality structure
  • Community Resource Teams
  • Nurse led clinics in GP practices
  • ? Relocation of Rehab programme
  • ? Physio / OT involvement

11
Anything Else?
  • Any Questions?
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