Heart failure affects an estimated 1 million adults in the UK and costs the NHS about £2 billion each year.  Heart failure reduces quality of life for patients and can lead to unplanned stays in hospital.  Cardiac rehabilitation has been shown to benefit patients and is cost-effective, however, less than 1 in 20 patients admitted to hospital with heart failure participate in cardiac rehabilitation.  People with heart failure can find it difficult to travel to hospital to take part in rehabilitation or may dislike group-based sessions.  Delivering rehabilitation in a more accessible setting, such as the patient’s home, offers the opportunity for more patients to take part.

The Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) programme is a home-based, cardiac rehabilitation and self-management programme, designed to improve the quality of life of people with chronic heart failure. It encompasses a comprehensive holistic self-management programme including a choice of tailored exercise programmes, a progress tracker, and relaxation and wellbeing resources. Demonstrated to be a clinically effective and cost-effective programme in a recent clinical trial, it has been rolled out across NHS trusts in England.

The SCOT: REACH-HF study, led by Professor Rod Taylor and Dr Carrie Purcell at the University of Glasgow, aimed to identify barriers to and facilitators of the programme’s implementation, in order to support potential roll-out across NHS Scotland. To best understand implementation of this programme, the study aimed to measure two key outcomes. Firstly, the outcomes for people with heart failure, and secondly the views and experiences of healthcare experts who would be able to provide insight into the feasibility of programme delivery.

The study findings were positive, with patients’ quality of life significantly improving between baseline and follow up of the intervention. There were also observed improvements in patient depression levels, confidence in managing their heart failure and their ability to understand and use health information in a way that was useful to them. The interviews conducted with health professionals about REACH-HF were mostly positive and many felt it had come at a good time when all other options for rehabilitation were severely restricted. It was recognised that the programme fills an important gap in accessibility, both in general and in relation to COVID-19. Most were keen to continue involvement with the programme and felt that it benefitted their patients.

To promote potential wider implementation of REACH-HF in Scotland, the SCOT: REACH-HF hosted a meeting with key NHS and government Scotland stakeholders on 5th September 2022 that provided an opportunity for dissemination of the study findings and a forum for discussion of wider national roll-out of REACH-HF. The overall consensus from the event was very positive, and progress is being made toward a potential introduction of REACH-HF across Scotland.