Building on success. Six months until the 2012 Edinburgh Annual Conference. with the second edition of the BACPR Standards

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1 The Newsletter from the British Association for Cardiovascular Prevention and Rehabilitation SPRING 2012 In this Issue Standards and Core Components Membership update BACPR Annual Conference 2012 Building on success with the second edition of the BACPR Standards Seven core standards and seven core components are set out which aim to improve uptake and quality of rehabilitation programmes nationwide. Six months until the 2012 Edinburgh Annual Conference 4th and 5th October 2012 Promoting excellence in cardiovascular disease prevention and rehabilitation

2 Message from the Editor Contents Top news 2 New publication 3 Membership update 4 Patient representative 5 International Charter 6 NACR update 7 Rehabwatch 7 Scotland s first CR audit 8 NHS Improvement update BHF update 10 EPG update 10 9 Charlotte-Anne Wells, Editor Spring is upon us and as we look forward to warmer weather and lighter nights, we hope that the continued hard work and commitment of all of those involved with BACPR, not least our council and President will continue to support and invigorate you as you with us strive to promote excellence in cardiovascular disease prevention and rehabilitation. Enjoy the read! Welcome note from the President Affiliates update 11 Regional news 13 News from members 15 BACPR Education 16 BACPR Annual Conference 18 Jenni Jones, President A very warm welcome as we begin another BACPR membership year. Thank you for your highly valued support in joining us to promote excellence in cardiovascular disease prevention and rehabilitation. Our Spring Special Edition Newsletter shares the incredible work of many individuals; each with a shared passion to provide the highest quality of care to our patients. You ll see from the many newspieces featured that your Council s efforts (all given completely on a voluntary basis, on top of their jobs, family commitments and more) are to be highly commended. On behalf of all the Association these efforts are recognised and greatly appreciated. Likewise, so too is your support as members. We continue to strive for your membership experience to be a positive and valuable one as top priority. Together our collective voice in championing for high quality service provision is far stronger.

3 TOP NEWS: Setting the standards Following continued work throughout 2011, we re delighted to enclose your personal copy of the new BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation This second edition builds on the success of the original 2007 version by incorporating the latest developments in the clinical evidence base for cardiac rehabilitation. There are seven standards together with seven core components, which aim to ensure programmes are clinically-effective, cost-effective and achieve sustainable health outcomes for patients. By adopting these standards and core components this will lead to the realisation of modern and effective cardiovascular prevention and rehabilitation services for the future. Our 2012 BACPR conference is themed Setting the Standards Challenges and Achievements and in a continued commitment to partnership working is being held in Edinburgh in collaboration with Cardiac Rehabilitation Interest Group Scotland (CRIGS). You ll also find a flyer for the next Conference in Edinburgh - a brilliant line up thanks to Gill Furze and the conference team. Reaching out nationally and internationally Through our collaborative work with CRIGS this has opened new opportunities to work more closely in the future. Partnership work is underway with the ambition that CRIGS becomes the regional group for our BACPR members from Scotland. We hope to build on this further making every effort for similar partnerships from across all four nations. We have also continued to develop stronger links with our affiliate partners BANCC, and BSH; both with co-opted representation now on BACPR Council. In May 2011 we held our second annual joint meeting at the BCS Conference and the 2012 BCS conference offers for the first time a whole BACPR- BANCC day programme devoted to prevention and rehabilitation. Our 2011 BACPR Conference in Brighton entitled Partnership Working to Improve Care developed international partnerships specifically with the European Association of Cardiovascular Prevention and Rehabilitation (EACPR) and with the Canadian Association for Cardiac Rehabilitation (CACR) as well as reached out nationally being delivered in association with BACPR-EPG, BANCC, BDA Heart UK, BHF, BSH and PCCS. Our international collaboration with CACR, attributable to John Buckley, has extended further to co-working on a joint members newsletter (CICRP), and co-chairing an international meeting in Vancouver in October 2011 that has led to the drafting and endorsing of an International Charter in Cardiovascular Prevention and Rehabilitation, which was presented this month at the WCC in Dubai. This Charter brings together ten organisations so far, from all over the Globe, in a call for better provision of cardiovascular prevention and rehabilitation services. Engaging with the members The BACPR has continued with its vision to reach out to its membership with more exclusive services and communications, through the leadership of Mima Traill together with Lulu Ho and the membership and communications team. We have developed a new website, with a members only area hosting a wide range of informative resources. For the first time BACPR-BCS joint membership is now an additional option. We ve also made significant advances in providing higher quality newsletters and informative publications. Thanks again to Charlotte Wells for her editorial mastery and everyone who has contributed to this newsletter and its accompanying material. Shaping your council We welcome our very first patient representative Mel Clarke to your Council. We also extend our thanks to Lucy Aphramor, who has stepped down from Council, for her valued contributions during her term of office. Next month we will be calling for nominations to Council so please do consider joining us in shaping the future of your association. You can find our Council handbook on our website, which gives you a feel for what is involved. Providing relevant and quality education Our Education department, directed by Sally Hinton working with the education and training team, continues to develop a wider array of courses relevant to the future of cardiac rehabilitation and not just the exercise component. We have now delivered more courses for lead clinicians and service managers on meeting Standards and Core Components; Psychology, Diet and with courses planned in the area of clinical and pharmaceutical management. In a membership year of many achievements our thanks extend to all our members and council members for their dedication and support, together with our key partnerships, in achieving our mission - to promote excellence in cardiovascular disease prevention and rehabilitation. Jenni Jones (BACPR President) 2

4 New publication: BACPR Standards and Core Components The second edition of the BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation was published in March Seven core standards and seven core components are set out which aim to improve uptake and quality of rehabilitation programmes nationwide. This BACPR update replaces the previous guidelines published in Patients, healthcare professionals and commissioners should expect the following from high quality cardiac rehabilitation services: 1. Introduction 3 1. Introduction The BACPR has defined seven standards and seven core components in support of promoting high quality care in the provision of structured programmes for cardiovascular disease (CVD) prevention and rehabilitation nationwide. Primarily, these standards and core components aim to ensure that all service providers, health professionals and service users, together with service commissioners where relevant, understand the requirements for providing cardiac rehabilitation that is both clinically and cost-effective, leads to appropriate patient satisfaction and results in an improved sense of well-being. These standards and core components also extend to any structured service aimed at improving cardiovascular health. With respect to the different health services that are in place among the four countries of the UK, these BACPR Standards and Core Components also aim to provide guidance that can be adapted to meet local needs and policies. Recognising that individual programmes throughout the UK face a future of various challenges, the aim is to move towards attaining the ultimate goal of having cardiac rehabilitation recognised as an obligatory, and not an optional or notional, element of any cardiovascular health care service. 1.1 Definition There are many definitions of cardiac rehabilitation [1,2,3]. The following definition presents their combined key elements: The coordinated sum of activities* required to influence favourably the underlying cause of cardiovascular disease, as well as to provide the best possible physical, mental and social conditions, so that the patients may, by their own efforts, preserve or resume optimal functioning in their community and through improved health behaviour, slow or reverse progression of disease. *The BACPR seven Core Components for cardiovascular disease prevention and rehabilitation constitute the coordinated sum of activities. In meeting these defined goals, all cardiac rehabilitation programmes should aim to offer a service that takes a multidisciplinary biopsychosocial approach in order to best influence uptake, adherence and long-term healthier living [4,5,6]. For each individual patient the involvement of a partner, other family member, carer, close friend (i.e. a significant supporting other) is also important. 1.2 Evidence There is overwhelming evidence that comprehensive cardiac rehabilitation is associated with a reduction in both cardiac mortality (26-36%) and total mortality (13-26%) [7,8,9]. Secondary prevention, including blood pressure and cholesterol management and the prescription of cardioprotective medication also forms an integral part of an effective cardiac rehabilitation programme [10]. There is emerging evidence that cardiac rehabilitation is also associated with a reduction in morbidity, namely recurrent myocardial reinfarction, [9,10] and a 28-56% reduction in costly unplanned readmissions [11,12]. Cardiac rehabilitation improves functional capacity and perceived quality of life whilst also supporting early return to work and the development of self-management skills [13]. This makes cardiac rehabilitation one of the most clinically and cost-effective therapeutic interventions in cardiovascular disease management [14-18]. The emphasis now is moving towards early cardiac rehabilitation, commencing within two weeks of either discharge or diagnosis. Starting within this timeframe has been shown to be both safe and feasible [19-22] as 2 British Association for Cardiovascular Prevention and Rehabilitation The delivery of seven core components employing an evidence-based approach. An integrated multidisciplinary team consisting of qualified and competent practitioners, led by a clinical coordinator. Identification, referral and recruitment of eligible patient populations. Early initial assessment of individual patient needs in each of the core components, ongoing assessment and reassessment upon programme completion. Early provision of a cardiac rehabilitation programme, with a defined pathway of care, which meets the core components and is aligned with patient preference and choice. Registration and submission of data to the National Audit for Cardiac Rehabilitation. Establishment of a business case including a cardiac rehabilitation budget which meets the full service cost. well as improving patient uptake and adherence [23]. The gains from early cardiac rehabilitation also include the potential to reduce unplanned readmissions early in the discharge period (within 30 days) thus yielding significant cost savings. 1.3 National and Local Factors for Assuring Quality Quality assurance is ensured through an alliance at both local (e.g. commissioners, service providers and service users) and national level [15,18] together with participation in the National Audit for Cardiac Rehabilitation (NACR) [24] (Figure 1). This alliance assures quality by providing a set of nationally recognised standards with appropriate mechanisms for systematic measurement and monitoring of processes to ensure that services are fit for purpose. Figure 1: Key Alliances in Assuring Quality Cardiac Rehabilitation Service Delivery *National Health Associations as they apply to England, Scotland, Wales and Northern Ireland 1.4 Cardiac Rehabilitation Pathway of Care The BACPR are highly appreciative of the support given by the BHF in endorsing this publication and facilitating its dissemination as part of the national campaign pertaining to what high quality cardiac rehabilitation looks like. We are grateful to our 2007 development group together with affiliated colleagues in cardiovascular care, who have participated in the consultation process and provided important feedback, including members representing: The British Cardiovascular Society (Dr Jane Flint); The British Heart Foundation (BHF) (Diane Card); NHS Improvement (Sarah Armstrong-Klein); The NACR Your local service NHA s*, SIGN NICE BACPR The Department of Health Commissioning Pack for Cardiac Rehabilitation [15] details a recommended seven stage (0-6) pathway of care from patient presentation (e.g. diagnosis or cardiac event), identification for eligibility, referral, and assessment through to long-term management (Figure 2). Whilst intended for England, this pathway of care is relevant to all four nations. Each of these stages within this process is vital for programme uptake and adherence, the achievement of meaningful clinical outcomes and ensuring longerterm behaviour change and desired health outcomes. The assessed information must also be managed in a manner to fulfil the need for audit and evaluation. It is important to recognise that care across this seven stage pathway may involve different healthcare settings and organisations. In the case of tertiary services the repatriation of patients this pathway is more complex. In these instances there is a responsibility of the service provider on the completion of any stage to effectively communicate the patient s clinical status and individual needs prior to their transfer of care. Standards and Core Components 2012 (2nd Edition) 3 BHF Cardiac Care and Education Research Group at University of York in managing the National Audit for Cardiac Rehabilitation (Prof Bob Lewin); The British Association of Nursing in Cardiovascular Care (Jan Keenan); The British Society for Heart Failure (Annie McCallum); Heart Care Partnership (UK) (Ken Timmins); the Primary Care Cardiovascular Society (Ann-Marie Johnson); and UK Heart Health and Thoracic Dietitians Group (Alison Mead), as well as healthcare professionals from our consultation event and BACPR council members past and present. Special thanks also to the primary writing group for their tireless efforts: Jenni Jones, Dr John Buckley (who also led the development group), Prof Gill Furze, Prof Patrick Doherty, Dr Linda Speck, Dr Susan Connolly and Sally Hinton together with Paul Lindt at Academy Design and Ian Hearn for the design and proof reading. Please do encourage all your colleagues to view the new BACPR Standards and Core Components visit: com/resources/15e_bacpr_standards_final.pdf IMPORTANT: The RAMIT trial by West et al This randomised controlled trial challenges cardiac rehabilitation in the UK. It has just been published in HEART (15 April 2012; Vol. 98, No. 8) together with two accompanying editorials and numerous letters - including that submitted by the BACPR. We recommend all BACPR members read all the responses to this controversial study. The Cochrane group clearly show with the addition of RAMIT data cardiac mortality remains beneficial. The RAMIT trial was conducted between 1997 and 2001 when we know the provision of cardiac rehabilitation was evolving and the intensity of care associated with the widely accepted and strong evidence-base was not being consistently met. Our new standards and core components continue to promote programmes that extend far beyond exercise and education and call for the provision of evidencebased comprehensive care delivered by specialists, proper funding to do this together with audit and evaluation as essential.

5 Membership update As a new or renewed member of BACPR you should have received information with your log in details for the website and your membership number. We hope that the resources BACPR have provided and will continue to develop are valuable and continue to offer you support. Collectively we present a much stronger voice and we trust that the resources and support that BACPR can offer you as a member of the association will help with many of the challenges being faced by those working in cardiac rehabilitation in this current climate. As we close one membership year and open another, for your information and interest, please find a breakdown of our April 2011 to March 2012 membership. We strive now for your continued support as well as reaching out to your colleagues for growing representation across all (but particularly those under-represented) professional backgrounds. Profession Membership numbers ( ) Nurse 305 BACPR Exercise Instructor 221 Physiotherapist 114 Other Exercise professional 39 Exercise Physiologist 34 Occupational Therapist 15 Doctor 15 Dietician 10 Research Fellow Academic 7 Psychologist 5 Other 29 Profession unknown 11 Total membership 805 Mima Traill (Honorary Secretary BACPR) Could you be the next BACPR Scientific Programmes Officer? As I am now President Elect, I will be stepping down as Scientific Programmes Officer. We will be requesting people to come forward for this role soon, but what does a Scientific Programmes Officer (usually just called Scientific Officer) do? I must admit, I was rather hazy about this when I was elected. I have found the role to be exciting, occasionally challenging, but very rewarding. The main role of the Scientific Officer is to chair the Conference committee and to devise (with help) a conference programme that we always hope that our members will appreciate. This has some upsides I ve had a lovely couple of days in Brighton and Edinburgh courtesy of the Tourist Boards, as they showed us what various hotels and venues could offer. Another key upside is the support and friendship you get from the conference committee this is a great team. In addition to the main conference and the BCS Affiliates day, the Scientific Officer also needs to be able to address issues that relate to the scientific evidence-base for CR as we recently had to do with regards the RAMIT trial (see our website for details about this). So you do need to know how to access the evidence but again you won t be alone other people on council will also help with this. In addition to attending the 4 council meetings a year, the additional time commitment needed is to be able to hold a telephone conference call for one hour a month with the rest of the team, time to send out s to speakers and to be able to give a couple of days over to visiting the venue. The Scientific Officer is a member of the Executive Coordinating Group for BACPR, so the quarterly council meetings are a full day. The rewards that you get at conference, as members enjoy the programme that you have helped to put on, is fantastic, and make your commitment worthwhile. If you take this on, we will let you in gently I ll still be part of the conference committee and will continue to sort out this year s conference. You would be able to shadow what is happening, and will take over the planning for the next conference. If you enjoy organising events then this may be the role for you! If anyone would like to chat through the role I m really happy to do that. Just me on gill.furze@coventry. ac.uk to set up a time to talk. Gill Furze I ve had a lovely couple of days in Brighton and Edinburgh courtesy of the Tourist Boards, as they showed us various hotels and venues 4

6 Patient representative joins BACPR Council Mel Clarke Co-opted Council member (Patient and Heart Care Partnership (UK) representative) Mel was introduced to the sharp end of NHS services in 1996 as a result of having Heart-by pass surgery. At that time, Cardiac Rehab was a real postcode lottery and but for the zeal and enthusiasm of a brilliant Cardiac Nurse, Mel would probably not be so involved in his current commitments towards Heart patients. Cardiac Rehabilitation became a fiery cross and Mel determined to do everything possible to obtain appropriate CR provision in his home area of North Yorkshire. He joined the local Heart Support Group and was elected Chairman in Mel currently is organiser and promoter of the Phase 4 Cardiac exercise programme conducted every week in the community, with most referrals emanating from excellent cooperation with Harrogate NHS Trust Cardiac nurses. In 2000, Mel was invited to join the NSF 2000 Cardiac Implementation team and later served with the Commission for Health Improvement as an auditor of Cardiac Rehab programmes in several hospitals. British Heart Foundation provided more opportunities via the inaugural Hearty Voices training. Mel became a member of the pioneer Patient Advisory Group, with subsequent involvement in the Prevention and Care committee, steering group member of NACR and BHF Campaign for Cardiac Rehab. He has pride in having been part of the team which constructed the most important DH Commissioning guide for Cardiac Rehabilitation. Much of Mel s time is still devoted to all these activities. His recent appointment as the first patient Council member of BACPR opens up new horizons with another opportunity to express viewpoints on behalf of all patients and hopefully contribute pragmatically to the future development of BACPR. BACPR-BANCC Affiliates Day at BCS Conference BACPR and BANCC Affiliates Day at BCS Prevention and Rehabilitation of Cardiovascular Disease Giving Patients a Sporting Chance 30 May 2012, Manchester This inaugural full day on the prevention and rehabilitation of cardiovascular disease, led by BACPR and BANCC, is hoped to become a regular feature of the BCS Annual Conference. It is fitting that it is being launched as part of this special year, 2012, based around an Olympic theme with relevance to sport, exercise, cardiology and cardiovascular health. Travel Award deadline August 31st 2012 You will have read about the inspiring visits completed by last years winners of the travel award in our last special edition newsletter and we are delighted to announce the opening of applications for the BACPR Travel Award Funding of up to 2,000 is available. Applications are welcome up until 31st August For regulations and application information please visit the Travel Award section of the website. 5

7 BACPR plays leading role in developing an International Collaboration and Charter on Cardiovascular Prevention and Rehabilitation An international collaborative charter on cardiovascular prevention and rehabilitation, to which BACPR has led in the development, has been drafted and will be presented at the World Congress of Cardiology (WCC), Dubai in April, This development has been born out of BACPR s partnering with the Canadian Association of Cardiac Rehabilitation (CACR) on their publication Current Issues in Cardiac Rehabilitation and Prevention (CICRP). Following meetings between BACPR and CACR in Vancouver in June 2009 and in Montreal in October, 2010, our Canadian colleagues applied for a grant with the Canadian Research Council. The grant pursued was based on the goal of developing ways of internationally harmonising messaging on the value of cardiovascular prevention and rehabilitation. BACPR partnered in the production and support of this funding application, which was successfully granted in January Between January and September 2011, two developments were achieved from the grant, with leading contributions from the CACR, BACPR and the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR): 1. The first drafts of the Charter were produced and 2. The organising and running of a first international meeting in Vancouver in October, 2011 at the Annual Congress of the Canadian Cardiovascular Society. This meeting involved a three hour interactive session, co-chaired by CACR President Bob Reid and BACPR Past President John Buckley, where many attended with representation from around the world via a web-based tele-conference system, including: Australia, Canada, Mexico, Brazil, Europe, Ireland, New Zealand, India, Hong Kong, the UK and the USA. The outcome of the meeting provided many important updates to the Charter to which BACPR Council members have now contributed many important developments. John Buckley BACPR (represented by John Buckley and Jenni Jones) will Chair the next International meeting at the World Congress of Cardiology in Dubai on the 19th April. Further discussions and plans will be put in place on how associations around the globe, like BACPR, can work together to increase the profile, recognition and growth of cardiovascular prevention and rehabilitation as an obligatory component of cardiovascular health care programmes. Below are the aims and focus of the current Charter, which has now been endorsed by: The American Association of Cardiopulmonary Rehabilitation The American Society of Preventive Cardiology The Association of Cardiovascular Health and Rehabilitation of Australia The BACPR The Canadian Association of Cardiac Rehabilitation The Canadian Cardiovascular Society The National Society of Cardiac Disease Prevention and Rehabilitation, India The Irish Association of Cardiac Rehabilitation The Cardiac Rehabilitation Association of New Zealand The Saudi Heart Association The current version of the Charter can be read in full on the BACPR website BACPR members are welcome to send in their comments to bacpr@bcs.com The International Charter on Cardiovascular Prevention and Rehabilitation Aims and Focus The two aims of this Charter are: i. To bring together national associations from around the world, to harmonize efforts in promoting cardiovascular prevention and rehabilitation; and ii. To document, for the first time, consensus among national associations globally, regarding the internationally-common core elements and benefits of cardiovascular disease prevention and rehabilitation. The focus of this Charter is on secondary prevention, which has well-established models supported by a robust evidence base. This Charter is visualised to fit at the latter end of a continuum from primary prevention in public health initiatives, through to secondary prevention. 6

8 NACR update by Corinna Petre (project manager) and Bob Lewin, NACR, University of York The NHS Information Centre for Health and Social Care, who develop and maintain the NACR database, are currently in the process of rewriting all of the databases held with them and some have already gone live. The NACR database will also be rewritten. This is an exciting prospect as they will be developing a system which will be more robust, easier to manage and will be entirely web based. It has been obvious for some time that Lotus was not up to the job and we are very excited to be moving to what will eventually be the same system used by all of the main medical audits. We have had an initial chat with the development team who are convinced they can make all our lives easier and mentioned a number of exciting extra things we may be able to offer users through linking to what will be the main data store for the NHS. The most immediate benefits are, that it will eliminate the need for IT departments to load Lotus and remove the Lotus licensing issue so that all rehab staff who need access will be able to securely enter and view data once they have been issued a login. The software will also allow more validation checks to ensure that the data is accurate. We expect the system to be extremely user friendly with plenty of help information for each data field and more reporting views of your data and we will ensure that you find the transition to the new system painless. The new version will make it easier for data to be imported from different systems and we are hoping will also, for the first time, enable data from SystemOne to be uploaded, an added bonus. We will be contacting all those companies that provide secondary software and currently import into NACR to make them aware of this change and enable them to link to NACR. Development won t be starting for several months and the roll out will be some time later this year. We will be doing extensive testing and refining of the system before we move over. At present this is all we know. As soon as we know more we will let our users know through our own Newsletter, s and splash screens. Rehabwatch by Bob Lewin The Cardiac Rehabilitation Research Group at York University is monitoring what is happening to CR programmes in light of the changes currently underway in the NHS. Electronic surveys are sent to the primary contact held on the Cardiac Rehabilitation Register (www. cardiac-rehabilitation.net) every 4 months. The third will have gone out early in April. So far we re averaging an 80% response rate, which is fantastic thanks to all of you who have replied. The first 2 surveys showed that while only 2 programmes had been told that they were to be closed down, one of which we know survived, a large percentage of programmes are going through a period of change and uncertainty. The main problem being reported is a loss of staff, both staff time and the number of disciplines available. The last three annual NACR reports highlighted the continuing trend for CR to become less multidisciplinary, it s clear that this worrying trend is continuing. However, it s not all bad news, 22% of coordinators reported changes that had improved their service but this has to be balanced against the 26% who reported that their service had been harmed. It s clear from both surveys that a lot of programmes are adopting new methods of delivering CR and that this includes better choice for patients and opening up to more patient groups. Please keep supporting the survey: as the new commissioning groups come into existence and private firms begin to bid for contracts, we need to ensure we are well informed and can provide data to show what is happening to our services and, if necessary, fight to preserve them. 7

9 Scottish funding and cardiac rehab audit feedback by Dr Iain Todd The subtleties of tariffs, PCTs, and GP Commissioning Consortia are lost on those of us who work north of the border. We watch the debate over the NHS Reform Bill with mild interest, grateful that having our own parliament appears to have at least saved us from the latest big idea to control the finances of the NHS. However, if the new tariff for CR delivers, we may yet regret not having a system in which funding is explicitly based on delivering a service to an individual at an agreed cost. Funding in Scotland sits with the providers while NHS Boards seek to ensure that mechanisms exist to direct that funding where it is most needed. Managed Clinical Networks, a Scottish concept, envisaged a partnership between primary and secondary care where decisions would be made about how best to spend the limited monies available, with patient representation there to ensure fair play and to remind us all of why we do what we do. Contrary to that early vision, they have never held control over the purse strings, being strategic rather than operational. They have no power to move funding from secondary to primary care or from acute care to rehabilitation. In 2010 NHSQIS published Clinical Standards for Heart Disease which included a recommendation to expand cardiac rehabilitation to all new patients with heart disease including those with recent onset of angina. The Scottish Government had already reacted to the first draft of those standards by recommending in its Better Heart Disease and Stroke Care Action Plan that NHS Boards should, through their cardiac MCNs, undertake a needs assessment process for all eligible patients, identify priorities and allocate resources. While acknowledging that the changing definition of MI had already increased the numbers being seen, and the broadening of eligibility criteria would dramatically increase numbers further, it was clear that there would be no additional central funding. Boards have shown little enthusiasm for moving funding from without CHD, and MCNs have no power to redistribute existing CHD funding. The choice for CR programme leads has been simple: do more with less, or don t meet the QIS standards. Available evidence suggests that most CR providers have done the best they can with existing resources by spreading them more thinly. The QIS clinical standards focused on identifying eligible patients, assessing their needs, and delivering against those needs using a menu-based approach. This sits comfortably alongside the DoH commissioning pack and the new BACPR standards. The Scottish Government made a commitment to meet BAC(P) R standards and to engage in national audit. Over the last 2 years CR programmes across Scotland have been completing audit forms which are currently being analysed by ISD. The first 6 months worth of data has just been published and is available at Topics/Heart-Disease/Topic-Areas/ Audits/index.asp? These data, being based on the NHSQIS standards, focus on referral rates and as such are not directly comparable to the NACR audit of uptake, but in a needs based assessment service, we need to consider whether the old definitions still have relevance. The audit does support the notion that we are seeing more referrals since the definition of MI changed, and we await further data to see the impact of widening criteria on referral and treatment rates for other CHD groups. In other aspects, there is much in common between the Scottish audit and NACR. The Scottish Government supports the concept of national audit, but prefers an approach involving short audits on specific topics of interest or concern rather than ongoing routine data collection. The new BACPR standards, however, include the provision of routine data to NACR for audit. It remains to be seen whether we can bridge that gap in ideology and deliver national audit which once again includes the four home nations. 8

10 NHS Improvement Update by Sarah Armstrong-Klein, National Improvement Lead Heart New on-line resource The CR Team at NHS Improvement are now at the end of the current national programme of work in assisting the NHS in improving access to and uptake of CR services through the development, roll-out and implementation of the DH Commissioning Pack for Cardiac Rehabilitation (2010). A new on-line resource entitled Quality, innovation and value in cardiac rehabilitation: commissioning for improvement will be available within the next few weeks and effectively captures the learning from this NHS Improvement work. The resource also references previous national projects led by NHS Improvement to drive up quality and efficiency in CR services. Quality, innovation and value in cardiac rehabilitation: commissioning for improvement will be available on the website at cardiacrehabilitation NHS Improvement and NACR Pilot project The joint project between NHS Improvement and the NACR Team has also reached its conclusion. This partnership pilot project set out to test some new and existing fields within the NACR database in order to extract the commissioner based CR service outcomes (as described in the DH CR Commissioning Pack) alongside clinical audit data. Look out for the report detailing the pilot project, including the aims, experiences from the sites involved, the project outcomes and the next steps. The report will be available within the next few weeks through the websites at www. improvement.nhs.uk/heart/cardiacrehabilitation and on Engagement Events for the Cardiovascular Disease Outcomes Strategy NHS Improvement is working in close collaboration with the Department of Health and NHS Diabetes and Kidney Care to coordinate a series of engagement events to enable stakeholders to contribute to the development of the new CVD Outcomes Strategy. Following a national event on May to which a select number of representatives from relevant professional, third sector and national organisations will be invited, there will also be one event in each of the new NHS Commissioning Board sectors: 24th May (North - Leeds) 13th June (Midlands/East Birmingham) 25th June (South Bristol) 27th June (London) The invitation list for each event is being drawn up with the help of the Cardiac and Stroke Networks and colleagues from NHS Diabetes and Kidney Care. The agenda for the regional meetings will mirror that of the national event and will include both plenary and interactive sessions. The primary aim will be to obtain participants views on the scope, main issues and priorities for the strategy. Further engagement events may occur in the autumn building on the outcomes from these initial meetings. For further information, please contact linda.binder@improvement.nhs.uk 9

11 BHF Update by Diane Card (Co-opted BHF representative BACPR Council) New Health at Work Resources Based on our new Mission Very Possible theme, promoting Health at Work has never been easier. A range of newly designed resources are available to order. The big three - be active, eat well and think well - have not only been updated but combined into one handy Health at Work Toolkit providing an in-depth how to guide to promoting health in the workplace. You can join our Health at Work Programme for free. You will receive your very own Welcome pack, monthly e-newsletter, access to our Health at Work resources and website, all designed to help you improve your health and wellbeing programme. Visit bhf.org.uk/healthatwork New Food cards (pack two) Use this additional pack of food cards as an interactive tool to demonstrate key food groups, improve your understanding of healthy eating and check the fat, salt and sugar content of everyday foods. Use alone, or in conjunction with Food cards pack one (G453c) and the award winning Healthy hearts kit (G453). Two information packed accompanying sheets, Food card glossary and Food card facts, can be downloaded from bhf.org.uk/ healthyheartskit New! Chest pain kit The BHF is delighted to announce the release of a new and exciting resource. The Chest pain kit is a flexible training resource, suitable for a wide range of audiences, which aims to: raise awareness of the signs and symptoms of a heart attack urge people to phone 999 immediately if they experience these symptoms, or see the signs in others help people overcome their barriers to calling 999 The kit has been produced to support anyone working in the field of community health promotion and includes interactive training aids to help trainers deliver their sessions easily and effectively. The kit is part of the BHF s Chest Pain Programme, which aims to raise awareness of these simple but vital messages in local communities across the UK. If you have any questions about the kit, please call Freya Burley on BACPR-Exercise Professionals Group (EPG) Update by Samantha Breen (Chair BACPR-EPG) The EPG steering group is made up of two representatives from each of: ACPICR, BACPR Exercise Instructor Network and BASES, as well as past chair, BACPR council link and founder member. The overall aim of the group is to develop practice standards and guidelines, offer CPD opportunities, and to advise professional groups / associations on matters pertaining to patient guidance and professional practice in relation to physical activity and exercise for cardiovascular disease and prevention. Current activities of the EPG include: Development of multi-professional competences Annie Holden is leading a project to write competences required to cover physical activity advice and exercise prescription from early rehabilitation to long term maintenance programmes. The first draft of the competences is currently being piloted in 8 sites across England and Scotland. Update of Position Statement The EPG Position Statement on essential competences and minimum qualifications required to lead the supervised exercise component in early rehabilitation has been updated and will be presented to BACPR council at their next meeting for ratification before being circulated to the membership. EPG study day 2012 The EPG conference committee has put together an impressive one day conference entitled Diabetes and Obesity: Meeting the Challenges in Physical Activity and Exercise to be held at Aston University Birmingham on Friday 11 May. Expert speakers include: Dr David Stensel, Dr Ian Gallen, Dr Frank Joseph, Professor Stuart Biddle and Dr Jason Gill. The study day is proving to be very popular, places are filling fast. So you don t miss out contact education@ bacpr.com for a detailed programme and application form. BACPR-EPG in association with Diabetes UK and the National Obesity Forum Diabetes and Obesity: Meeting the Challenges in Physical Activity and Exercise May 11th 2012 : Aston University Birmingham For further details or education@bacpr.com 10

12 Our key affiliates was packed with contemporary presentations by International experts in Cardiovascular nursing and was undoubtedly an exciting and thought-provoking event. British Association for Nursing in Cardiovascular Care (BANCC) BANCC Annual Study Day 2012, 27 April 2012, Crowne Plaza Hotel, Nottingham By the time this April edition of the BACPR newsletter reaches your letterbox, the BANCC Annual Study Day may have already taken place. Andrea Manley and colleagues organised an exciting agenda with expert national speakers including Jenni Jones, BACPR President and John Buckley, BACPR Past President. BCS Annual Conference, May 2012, Manchester Central Into the summer, John Buckley, BACPR has coordinated a BCS Affiliates Day at the now familiar haunt of Manchester Central at the British Cardiovascular Society Annual Conference. BANCC are delighted to be co-hosting with BACPR. As you might expect the day majors on prevention and exercise, given that there is rather a large exercise-focused event taking place in East London a few more weeks down the line! Nonetheless BANCC have retained sessions on the acute care of the cardiovascular patient and I m sure that the carefully constructed agenda will appeal to many delegates. Networking national and international counterparts and external stakeholders Catriona Jennings (BANCC President Elect) and I wrote a joint letter in January 2012 to the Council on Cardiovascular Nursing and Allied Professions (CCNAP) and Presidents of key national cardiovascular nursing societies. The aim was to generally introduce BANCC and outline its objectives and future goals so that channels of communication can be opened up. BANCC have already received good feedback from a number of Presidents, and look forward to opening up channels of communication with them in the near future. BANCC continue to regularly collaborate with prominent bodies such as NICE, BHF, RCN, CCNAP in the development and reviews of current practice and strive to represent cardiovascular nurses when possible. I attended the 12th Annual Spring Meeting in Cardiovascular Nursing, March 2012, Copenhagen at which BANCC were represented in 3 meetings with International colleagues, 1 invited oral presentation, 1 abstract presentation and 1 poster presentation. The agenda for the Copenhagen meeting Membership and Marketing BANCC realise at the moment there is no information or data available which demonstrates just how many cardiovascular nurses are currently practising in the UK. Jacqueline Hunt (BANCC Honorary Secretary) and colleagues have been tirelessly gathering information to try and find the answer to this question. This will not only prove useful now, but in the future, as it may demonstrate how the numbers may change. Jacqueline and her colleagues are also in the process of redeveloping the BANCC website. The new pages will have a more prominent BANCC identity and user friendly portals to find out more about what BANCC can offer its members. Cardiovascular Research Christi Deaton, BANCC cardiovascular nursing research lead, has carried out an important piece of work to look at which educational institutions in the UK offer research expertise for cardiovascular nursing. Christi focussed on the 36 Universities that submitted for Nursing and Midwifery in the 2008 RAE, plus a few others where she knew that there were CV nurse researchers. This is not an exhaustive search, and it was made more difficult because nursing does not organise its programmes or research by organ systems, websites do not make it easy to find information, and nurse researchers may be in non-nursing departments. BANCC would appreciate any feedback. Further details can be found on the BANCC website ( and finally, looking ahead to 2013, it will be with great pride that I accept the proverbial CCNAP flame in Copenhagen in lieu of CCNAP 2013 which will be held in the UK, in Glasgow. This will be a marvelous opportunity for us to showcase the best of British when we co-host this important international meeting. Work is already well underway on this exciting project and I will undertake to keep our members updated in the year ahead. So, a busy year! As ever, BANCC is and remains the society for cardiovascular nurses. For further information on BANCC, please visit our webpages at tel: , bancc@ bcs.com Dr Scott McLean, President, BANCC 11

13 British Society for Heart Failure (BSH) values the affiliation with BACPR in promoting cardiac rehabilitation for people with heart failure. Cardiac rehabilitation forms one of the NICE Quality Standards for heart failure. BSH is committed to promoting and teaching evidence based management and treatment of heart failure, disseminating key innovations, research and clinical management. The annual meeting in November 2011 concentrated on the needs of the individual patient with lectures from leading clinicians on co morbidities associated with heart failure, genetics, surgery and lifestyle issues such as flying, exercise and pregnancy. BSH medical and nursing teaching days in February each year are fully subscribed with excellent evaluation by attendees. BSH will present a heart failure case study along side BACPR at the British Cardiac Society this year and the Society looks forward to further collaboration with BACPR in the future. For further information about BSH: Annie MacCallum (Co-opted BACPR Council member) Observer to the Board British Society for Heart Failure Heart Care Partnership (UK) Mel Clarke now joins BACPR representing the patient voice and HCP (UK). HCP (UK) was set up in 2003 in response to a request from the British Cardiovascular Society, to draw together users that could represent patients and carers within the process for cardiac service improvement. This year they too have a full day at the BCS conference with a great line up of speakers including the new BCS President Iain Simpson, Professor Patrick Doherty, Dr Jane Flint and many more... HCP (UK) Annual Conference Enabling the Patient Voice In memory of David Geldard MBE Tuesday 29th May 2012, Manchester Central For more information visit their pages on the BCS website Mel Clarke (Co-opted BACPR Council member representing HCP (UK)) Primary Care Cardiovascular Society Ceases Operating An Extraordinary General Meeting of the PCCS was held in January where there was a unanimous vote in favour of the motion To approve the proposed voluntary winding up of the PCCS, its dissolution and removal from the Central Register of Charities. Since the PCCS was established 15 years ago, it has relied heavily on the pharmaceutical industry to support its educational activities. The recession and patent expiries have had a significant impact on the pharmaceutical industry and the availability of funds for all activities, including the PCCS. This situation is likely to deteriorate rather than improve for the foreseeable future. As the funding model for the PCCS is largely based on income from the industry, its future could not be guaranteed. Although the PCCS is currently solvent, looking forward, with the changes within the major funding sources, remaining solvent would be a challenge. The PCCS has been well managed and all financial matters are in order with a small surplus of funds. Once the winding up procedure is completed, the remaining balance will be gifted to a like-minded national cardiovascular charity. Ann Marie Johnson (Co-opted BACPR Council member representing PCCS) 12

14 Regional news British Heart Foundation Cardiac Rehabilitation National Campaign Update England There has been a lot to celebrate in England. We ve seen the publication of the Department of Health s (DH) Commissioning Pack, the BHF and NHS Improvement s booklet to help heart patients in England understand what they may now expect from a Cardiac Rehabilitation programme, and the new NICE guide on Cardiac Rehabilitation Services. In January 2012 the National Institute for Clinical Excellence (NICE) ran a consultation on proposed new indicators for the QOF. This confirmed the intention to include indicators on Cardiac Rehabilitation from 2013/14. It s also great news that Cardiac Rehabilitation has been included by NICE as a proposed indicator in the Commissioning Outcomes Framework, which will be used to judge the performance of the new clinical commissioning groups in the future. Finally, the DH Payment by Results team announced recently that Cardiac Rehabilitation has been approved as one of the first post discharge tariffs, which creates a real opportunity for programmes to offer it much earlier. This will not only improve the quality of care for patients but has the potential to reduce unplanned readmissions and save money. But there is more to do. We know, from the National Audit for Cardiac Rehabilitation (NACR), funded by the BHF, that in England in , only 43% of people in England who had a heart attack, bypass surgery, or an angioplasty took part in Cardiac Rehabilitation. Whilst we must ensure that action at a national level, as outlined above and including influencing the recently announced CVD Outcomes Strategy to ensure Cardiac Rehabilitation is prioritised, we must also ensure anything put in place isn t undermined by the NHS reforms and climate of financial austerity on the ground. This is the campaign s next challenge, and we very much hope the BACPR and its members will help us. Scotland We have been championing Cardiac Rehabilitation in Scotland and the campaign has experienced some great successes recently. Scottish Cabinet Secretary for Health and Wellbeing, Nicola Sturgeon, has stated that Cardiac Rehabilitation, along with specialist Heart Failure services, are her top priories for heart disease going forwards. She has been supportive of the Scottish campaign and its key themes along with the National Clinical Lead for Heart Disease Dr Barry Vallance. DrVallance who chairs the National Advisory Committee for Heart Disease endorses our campaign aims for Cardiac Rehabilitation and has encouraged the NHS Boards in Scotland to make it a priority. The Scottish Government has taken on the funding of the rehabilitation audit in Scotland. Early results from the audit show that good progress has been made in heart attack and heart bypass patients but more efforts are needed with conditions such as heart failure. To find out more about the National Campaign for Cardiac Rehabilitation, contact Laura Chu chul@bhf.org.uk or call Wales Last year s NACR (2011) showed that the number of heart patients taking part in Cardiac Rehabilitation is still too low (35%) in Wales. This shows no real improvement on 2008/09. This, as well as a change in NHS reorganisation in Wales two years ago which undoubtedly led a conservatism in decision-making and changing patterns of service delivery, makes it even more important to maintain and reinvigorate our campaigning work. We met with the new Health Minister in Wales, Lesley Griffiths AM in October last year and she was presented with a clear view of our campaign aims, and outcomes of the audit. She is very aware of the work that needs to be done to make sure that CR is taken up within the patient pathway. To this end we have been invited to help steer the outcomes strategy of the newly drafted Cardiac Disease Delivery Plan. This gives us an opportunity to further influence the way CR services are delivered in Wales. Far from being complete, our work in Wales will continue with a maintained focus on ensure that every Local Health Board adopts a clear patient pathway and service specification and integrates Cardiac Rehabilitation into care planning processes so that it is offered to every eligible patient in Wales. 13

15 Northern Ireland The 2011 NACR Report showed that the number of heart patients taking part in Cardiac Rehabilitation is still too low (40%) in Northern Ireland. Though there has been an increase in participation since 2008/09 (30%), BHF Northern Ireland believes more needs to be done. Over the past year, we have been championing the inclusion of Cardiac Rehabilitation within a Long Term Conditions policy framework and as a member of the Long Term Conditions Alliance Northern Ireland (LTCANI); we worked closely with the Department of Health, Social Services & Public Safety (DHSSPS) to develop a framework. In June 2011, our hard work paid off with the publication of a draft framework. Officially launching in spring 2012, the Long Term Conditions policy framework outlines how the Northern Ireland health service aims to meet the needs of people living with one or more long term conditions such as heart disease. This Framework has been identified as a key priority within the Northern Ireland Executive Programme for Government. The Programme for Government is committed to enrolling people who have a long term condition and who want to be enrolled, in a dedicated chronic condition management programme. With such a policy commitment, we are now turning attention to making sure Cardiac Rehabilitation is taken forward within local commissioning plans. Our work will focus on raising awareness of the inclusion of Cardiac Rehabilitation within each of Northern Ireland s five Local Commissioning Groups (LCGs) action plans. As we move forward, we will continue to campaign to make sure this policy commitment becomes reality and that every eligible heart patient (including angina and heart failure) is offered a comprehensive Cardiac Rehabilitation programme in Northern Ireland. Department of health update for England by Prof. Patrick Doherty, Chair of Rehabilitation, National Clinical Lead for Cardiac Rehabilitation (Heart Improvement) The new guidance for introduces the concept of post-discharge tariffs in four key areas, including cardiac rehabilitation (CR). The recent announcement from PbR that CR is one of the first Post Discharge Tariffs (PDT) is a real opportunity for clinicians to offer robust CR much earlier which will not only improve the quality of care for patients but has the potential to reduce unplanned readmissions and save money. The new BACPR Standards and Core Components clearly stress the importance of early CR and the PDT will support programmes to deliver new early assessment initiatives within the first 30 days post discharge. The NHS supports this approach and has made it clear, in its commissioning guidance, that cardiology services should reinvest savings from reduced readmissions back into CR programmes that delivered the improve services. PDTs for CR will take effect from April 2012 where early adopters can benefit and will become mandatory in April For further guidance for services in England please visit: PublicationsPolicyAndGuidance/DH_ Two Interim National Clinical Directors appointed As many will know the Secretary of State for Health, Andrew Lansley, announced last December that the government would be developing a new strategy for cardiovascular disease, under the direction of Sir Bruce Keogh (NHS Medical Director). As part of this work two Interim National Clinical Directors (NCDs) have been seconded to the Department of Health; Professor Huon Gray for Cardiovascular Disease (University Hospital of Southampton), and Dr Damian Jenkinson for Stroke (Royal Bournemouth Hospital). Both are part-time secondments and together cover the work previously overseen by Professor Sir Roger Boyle, before his retirement last summer. Members may wonder why their titles are prefaced by the word Interim. This is because no appointments could be made by the Department of Health (DH) whilst the Health & Social Care Bill was still being debated in Parliament, and pending the anticipated establishment of the NHS Commissioning Board (NHSCB). Much of the current DH clinical leadership will transition to the NHSCB once it is fully formed, and roles and responsibilities are likely to be reconsidered in Both NCDs took up their posts at the beginning of March, and work on the cardiovascular strategy has begun, involving other NCDs. The BCS and other key stakeholders will be consulted over the next few months as the scope is determined and the document developed, in anticipation of its publication towards the end of the coming financial year. Members should be kept informed of developments via BCS communications and also through local Network engagement, and any comments members wish to make would be welcome through these channels in the first instance. 14

16 News from members Inverclyde Globetrotters have Landed! They ve made it. Just after our last newsletter was published the Inverclyde Globetrotters Lunar Module landed on the Moon thanks to masses of help from Chest, Heart and Stroke Scotland (CHSS). The CHSS Lunar Trek to help the Inverclyde Globetrotters achieve their goal of walking to the Moon was launched on 1st September 2011 and thanks to other CHSS affiliated groups from Orkney to Dumfries, local groups from Inverclyde, staff from Glasgow Caledonian University and a few cardiac rehabilitation Phase III classes in and around Glasgow the 238,857 mile mission was successfully completed on 12th January 2012 after only 17 weeks. The Inverclyde Globetrotter s immediately blasted off again on the long haul back to Earth. At least it s all downhill! They re now covered over 17,500 miles on their homeward leg. Since they started using pedometers 4 years ago to help keep them active between their weekly Phase IV classes, the Inverclyde Globetrotters have walked over 63,000 miles million steps. If anyone would like to help them get back to home, please contact their exercise coach, Duncan Galbraith on ig1@talktalk.net You can now follow the exploits of the Inverclyde Globetrotters on Facebook! 8th World Congress on Active Ageing Glasgow Caledonian University has teamed up with the BHF National Centre for Physical Activity and Health at Loughborough University to stage the 8th World Congress on Active Ageing in Glasgow in The programme is designed to celebrate the diversity of ageing and, in particular, will focus upon the needs of the oldest and frailest population, often excluded from both research and practice. The week long Congress has strong day themes to attract professionals. One of the day theme, Working with those with cardiovascular and respiratory conditions runs on the Fri 17th August and will cover a number of aspects related to evidence. Symposia on Active environments (building, planning and technology/it); Training of exercise, health and social care professionals; Motivation to take up and adhere to physical activity and exercise; Measurement of physical activity and exercise outcomes and Practical Workshops such as Working with patients with heart failure, alongside Meet the Expert Sessions should allow you to find the answers to your questions on how to work effectively with older people with chronic medical conditions. The uniqueness of this event is the engagement with older people and their carer. They will have their own programme of events, including a large Experience Zone that will allow them to taste a variety of different activities and engage with health and fitness professionals. To find out more about the event, what s on the programme and the costs to register, visit Working with those with cardiovascular and respiratory conditions The Earlybird registration cost of 150 a day will finish on April 30th. 15

17 BACPR Education The Education team are now settled into the new office and working hard on planning the education programme for the next 12 months across the UK and the Republic of Ireland. The preview event for the BACPR Standards and Core Components was well evaluated and there are plans to organise a day later in the year to look at the 2012 Standards, commissioning and to discuss how to implement the new standards. Close links are maintained with the Register of Exercise Professional (REPS), Skills Active and Fitness Industry Association (FIA) to improve standards across exercise referral and we continue to deliver the highly acclaimed BACPR Exercise Instructor Level 4 cardiac course. All courses are constantly re-evaluated and peer reviewed to ensure our BACPR Education Programme is up to date and evidenced based. The next phase of developments include e-learning, adding to the course portfolio and installing a new database. The Physical Activity and Exercise in Heart Failure: Assessment. Prescription and Delivery Study day held at Scotston Stadium, Glasgow on the 3rd of February This study day provided an informative outline about heart failure and introduced the points of physiology which should be considered when exercising this group of patients. The case studies offered the valuable opportunity for the mixed group of health care professionals and Hatter Institute, UCLH, 23rd March 2012 BACR trained exercise instructors, to discuss their experiences and offer views on assessing and managing the example patient s exercise prescription. I found the course extremely useful for my practice and did raise my awareness of the effect physical activity can have on this group of patients. I also gained some practical knowledge regarding adapting exercises. Through discussion with the BACPR trainer and other delegates at the workshop, I was encouraged to think about the cardiac rehab groups I am involved in and challenge some of our current practice regarding assessment and exercise prescription. Judith Downie, Specialist Cardiac Rehab Nurse. Forthcoming BACPR Courses Physical Activity and Exercise in the Management of Cardiovascular Disease Part 1: Principles and Practicalities Provides a foundation programme in the principles of physical activity and exercise in the prevention and management of cardiovascular disease 9th - 10th June 2012, Coventry 30th June - 1st July 2012, Cardiff 7th - 8th July 2012, Manchester 28th - 29th Sept 2012, Central London Physical Activity and Exercise in the Management of Cardiovascular Disease Part 2: Advanced Applications Extends the core knowledge, understanding and skills gained in Part 1 to further clinical reasoning for the inclusion of the higher risk and complex cardiac patient. An excellent follow on to the BACPR Exercise Instructor Training. 27th - 28th April 2012, Central London FULL 29th - 30th June 2012, Newcastle 10th - 11th November 2012, Cardiff 24th - 25th November 2012, Manchester 1st - 2nd December 2012, Coventry 8th 19th January 2012, London continued >> 16

18 Physical Activity and Exercise in Heart Failure: Assessment, Prescription and Delivery Do you want to find out more about heart failure and exercise? 1st June 2012, London 21st September, Alton, Hampshire 20th October 2012, Manchester Adapting Exercise: Enhancing skills to accommodate all abilities from seated to high level activity within a group setting Focuses on developing leadership, teaching and delivery skills to facilitate a safe, effective and well-managed programme to a functionally diverse client group 28th April 2012, Dublin Monitoring Exercise Intensity ( HR, RPE and METS) A practical course involving a day of workshops exploring how to ensure effective monitoring of exercise intensity 25th May 2012, Chichester How to administer and interpret sub maximal tests in clinical populations Practical course looking at the most commonly used functional capacity tests e.g. Incremental Shuttle Walk Test, 6- Minute Walk Test, Chester Step Test and Cycle Ergometry 19th October 2012, London Psychological Support and Health Behaviour Change in Cardiovascular Disease Explore ways of incorporating psychological principles within your service 23rd/ 24th Nov 2012, Central London Reducing the Risk of Cardiovascular Disease and Managing Weight: A Dietary and Behavioural Approach Useful tips and suggestions that can be implemented into practice 9th November 2012, Central London BACPR Level 4 Exercise Instructor Training Qualification Delivered at many different venues across the UK- see For application forms education@bacpr.com For further details of the education programme visit If you would interested in hosting one of the courses in your area please contact one of the education team BACPR Education, Suite 8, The Granary, 1.Waverley Lane, Farnham, Surrey GU9 8BB Tel: Fax: Diary of events BANCC Study Day 27th April 2012, Crowne Plaza, Nottingham BACPR-EPG Spring Study Day 11th May, Aston University, Birmingham Heart Failure Congress th 22nd May 2012, Belgrade, Serbia 7th International Nurse Practitioner/Advanced Practice Nursing Network Conference 20th 22nd August 2012, Imperial College, London BCS Annual Conference th 30th May, Manchester Central EuroPRevent 2012 May 3rd 5th, Dublin Prevention of Cardiovascular Disease 5th 6th July 2012, Imperial College London 8th World Congress on Active Ageing 13th 17th August 2012, Glasgow European Society of Cardiology Annual Congress 25th 29th Aug 2012, Munich, Germany Heart Rhythm Congress rd 26th September 2012, The ICC, Birmingham BACPR Annual Conference th 5th Oct 2012, Edinburgh First Conference Centre British Society for Heart Failure 15th Annual Autumn Meeting 29th 30th November 2012, Queen Elizabeth II Conference Centre, London Disclaimer: The British Association for Cardiovascular Prevention and Rehabilitation (BACPR) is not responsible for the contents or reliability of any of the content included. The advertisement of non-bacpr courses and conferences is for information to our members and does not represent our endorsement. 17

19 BACPR ANNUAL CONFERENCE 2012 in association with CRIGS*: Setting the Standards: Challenges and Achievements Thursday 4th & Friday 5th October, 2012 Edinburgh University John McIntyre Conference Centre Our conference this year is based on helping you to deliver the new BACPR Standards and Core Components, 2nd Edition. Our great programme includes: Opening address from Nicola Sturgeon MSP: Deputy First Minister and Cabinet Secretary for Health, Wellbeing and Cities Strategy. Keynote lectures from internationally renowned experts Professor Bonnie Sanderson (AACVPR): Masterclass on lifestyle risk reduction Professor Keith Fox (BCS): Masterclass on optimised treatment in acute CHD Professor John Deanfield: Joint British Societies Guidelines V3 Professor Rod Taylor: The latest evidence in setting the standards Dr Jeff Breckon: Motivational Interviewing How To Dr John Payne: Heart Failure, LVADs and cardiac rehabilitation Parallel sessions Erectile dysfunction: Dr Mike Fraser Medication adherence: Dr Gerry Molloy Weight reduction in CR a debate: Prof Gary Frost and Dr Lucy Aphramor The latest on exercise in diabetes and obesity And there s more... Championing Cardiac Rehabilitation: Julia Toft, BHF Building the business case for CR: Mel Varvel, NHS Improvement Oral and poster presentations Gala dinner with disco (and there may be a couple of Ceilidh dances in there too!) I certainly can t wait! You can view the full programme on the BACPR website. Registration is now open. You can apply using the flyer enclosed. Online registration is also available See you in Edinburgh. Gill and the conference team (*CRIGS: the Cardiac Rehabilitation Interest Group Scotland) Abstracts are invited for submission no later than 30 June 2012 for oral or poster presentation. Abstracts giving details of research or innovation in cardiac prevention and rehabilitation will be considered for oral presentation in the breakout sessions. Submissions on the topic of Overcoming challenges to meet the standards will be particularly welcome. Abstracts should: Be submitted by to bacpr@bcs.com. Please send as a.doc attachment Be no more than 250 words in length Be in word format using 12 point size Arial font Have a title in capital letters, and the organisation involved The name(s) of the author)s) must be preceded by initials only Omit titles and degrees and underline only the main presenter Add full postal address and address of the main presenter at the end Please indicate your preferred form of presentation; oral or poster. The best abstracts accepted as a poster will be invited to present their poster in a moderated session. There will be prize plaques for best abstract accepted for oral presentation and for best moderated poster. If you have not received an confirmation of receipt from the BACPR co-ordinator within 10 working days of submission, please re-submit abstract or call Conference registration is mandatory for any format of presentation. NOTE: BACPR members who have abstracts accepted will be offered conference registration at the early bird rate of 175 for the combined package with Gala dinner (usually 200). The non-member rate remains 280 and the day rate is 125 for BACPR members and 155 for non-members. For further details about the conference visit the BACPR website: Or contact Lulu Ho on bacpr@bcs.com Tel: BACPR, c/o BCS 9 Fitzroy Square, London W1T 5HW bacpr@bcs.com

20 BRITISH ASSOCIATION FOR CARDIOVASCULAR PREVENTION AND REHABILITATION Promoting excellence in cardiovascular disease prevention and rehabilitation The British Association for Cardiovascular Prevention and Rehabilitation British Cardiovascular Society 9 Fitzroy Square, London, W1T 5HW bacpr@bcs.com Direct Line: +44 (0) Fax: +44 (0) Website: Registered Charity Number Company limited by guarantee. Registered in England