Cardiac Rehab Service
North East Wales
Wrexham & FlintshireWrexham & Flintshire
..& a bit of Denbighshire, Shropshire, Cheshire
Quick guide to the service
• Context
– Team
– Links with other teams
• Service offered• Service offered
• Criteria for CR
• Challenges
• Opportunities
Oop North
Oop North
Oop North
The great cardiac tapestry
• Nurses – Jacqui, Kate, Lorraine, Bernice, Jo & Nina
• Exp phys – Susanne, Andrew, Jo• Physio – Claire• OT – Dawn & Rachel• Secretaries – Leanne, Angela,
Louise (HF), Alison (arrhythmia)
• CR sp• HF sp• Acute CPN sp• Arrhythmia sp• Lipid sp• ACHD sp
Louise (HF), Alison (arrhythmia)
• Dietitian - Paul• Pharmacist - Tina• Ph IV team – Audra, Gaz & others• Clinical Psychiatrists – Rob &
John
• Ward team• Consultant• GP• PN• DN• Cardio-resp• YGC, COCH• BHF
Two heads are better than one..
Two heads..
• Highly specialist skills, knowledge, experience
• Generic CR skills, knowledge, experience
Two heads..• Complex cardiac +/-
psychological +/-physiological +/-pharmacological needs. Eg refractory angina, devices, GUCH, MSK, devices, GUCH, MSK, fear
• Generic full CR assessment, cardiac knowledge, generic advice, motivation, coaching, empowering
Assess, assess, assess
• Who is this person?– Role in life
– Skills they have for managing change, health, life events
– Resources they draw upon
– Experience in life
– Aspirations
– CHD RFs
– Effects of cardiac event
Plan steps forward
• Where is individual aiming to go?
– Realistic?
– Achievable?
– Individual-centred (not HCP centred????)– Individual-centred (not HCP centred????)
• Goal setting & modifications
• Mobilising resources
• Learning – skills, knowledge, beliefs, attitude
How
• Phone
• Visit
individual
• Individual visit
• Assessment, advice,
information, guidance,
counselling, coaching,
listening….• Individual visit
us
• Written info
• Exercise, mobility, activity
assessment
• Exercise, activity sessions –
once per week
• Group & individual
educational sessions
Criteria
Keeps expanding…
Challenges & Opportunities
• Two teams become one
• More complex needs recognised
• Working without psychologist
• Funding• Funding
• NACR – fitting into a box