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Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.

Cardiac rehabilitation

Cardiology · UK scope · Sources checked 27 Aug 2026 · Clinical review pending

RapidFull

Synopsis

Identify eligible patients, make a timely referral and understand the personalised assessment, delivery and outcome measures of UK cardiovascular rehabilitation.

  • Offer cardiac rehabilitation with an exercise component to all people after MI irrespective of age; ACS, PCI/CABG and chronic heart failure are NHS England priority cohorts when capacity is constrained.
  • Begin the rehabilitation conversation during admission and invite the person to a session that starts within 10 days after discharge following MI.
  • NHS England expects provider contact within five working days of referral and a holistic initial assessment within 10 days of receipt of referral.
  • A complete programme combines tailored aerobic and resistance exercise with education, risk-factor management, medicines optimisation, psychological support and long-term self-management.
  • Offer in-person, remote or hybrid delivery according to preference and access; digital exclusion is a reason to adapt, not to exclude.
  • Assess comorbidity and clinical stability before exercise; unstable angina, decompensated heart failure or uncontrolled arrhythmia needs medical review before progression.
  • Re-contact people who do not start or who drop out, and record baseline and final outcomes rather than counting referral alone.

Investigation priorities

01
Holistic baseline assessmentFirst step

Define goals, comorbidity, function, preferences, social context and readiness for change.

Management branches

First-lineIdentify and refer

Eligible cardiovascular event, procedure or diagnosis

  1. Introduce rehabilitation before discharge or at diagnosis and explain exercise, education, medical and psychological components.
  2. Send a direct referral with diagnosis, procedure, ventricular function, medicines, complications, mobility/communication needs and contact details.
  3. For MI, invite to a programme starting within 10 days after discharge; the NHS England service standard is provider contact within five working days of referral.
  4. Give a route for the patient and primary-care team to chase a missing contact.
Third-lineDeliver and review

Medically stable participant

  1. Deliver exercise, education, diet/weight, tobacco cessation, psychosocial support, medical risk management and long-term strategy components.
  2. Monitor symptoms and exertion at each contact; stop and clinically assess new chest pain, presyncope, dangerous rhythm or decompensation.
  3. Re-contact non-starters and dropouts using motivational, practical support and alternative delivery modes.
  4. Repeat baseline outcome measures at completion and provide a shared discharge/self-management plan.
Open full textbook →Answer 2 questionsCardiology check
Sources and review status4 sources · checked 27 Aug 2026 · clinical review pending+
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Apply principles in context and verify current guidance when a decision affects care. Source check completed 27 Aug 2026; clinical approval remains outstanding.

  • NHS England: Commissioning standards for cardiovascular rehabilitationDecember 2024 eligibility, access, pathway and quality standards.
  • NICE NG185: Acute coronary syndromesPost-MI offer, timing and programme components.
  • NICE NG106: Chronic heart failurePersonalised exercise-based rehabilitation for heart failure.
  • NICE QS99: Secondary prevention after myocardial infarctionQuality standards for post-MI care.

Editorial contact: Doctor’s Passport editorial team. Source-check date is separate from clinical approval. Report a content problem · Content changes

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom