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The service is run across four sites in Hertfordshire and patients can attend whichever centre is closest to them. When the referral is received, depending on diagnosis, the patient will have a telephone support call or a letter with an appointment for an initial assessment.

Initial assessment

This is a one hour appointment to ensure that clinicians have all relevant information for the patient to progress safely through the programme. Observations such as blood pressure, height and weight will be taken and risk factors discussed.

Every week patients attend both an exercise session and an education session.

Exercise test

Before commencing the exercise sessions, and again at the end of the programme, patients will be asked to complete a short exercise walking test to ensure that they are exercising at the most appropriate level for their needs. The exercise sessions are aimed at providing cardiovascular exercise and are circuit based. There is always a warm up and cool down included with a short relaxation session at the end. Patients are monitored throughout.

Education session

There are health education sessions which include:

• how the heart works and cardiac procedures
• risk factors for heart disease
• making changes
• managing medication
• emotional and psychological aspects of heart disease
• healthy eating - for your heart
• benefits of exercise

Questions and discussion are encouraged at all sessions.

One to one support and workshops are available for diet and stress management information. Patients with a diagnosis of heart failure have an additional workshop with advice specific to their condition.

At discharge, patients will have a review meeting to discuss progress and plans for managing their heart condition for the future.

Phase four exercise classes

These follow on from the Cardiac Rehabilitation Programme and are organised by local heart support groups and leisure centres with appropriately trained instructors. Information is provided before discharge from the programme.