Cardiac Rehab Service North East Wales Wrexham & Flintshire ..& a bit of Denbighshire, Shropshire, Cheshire Quick guide to the service • Context – Team – Links with other teams • Service offered • Criteria for CR • Challenges • Opportunities Oop North Oop North Oop North The great cardiac tapestry • Nurses – Jacqui, Kate, Lorraine, • CR sp Bernice, Jo & Nina • HF sp • Exp phys – Susanne, Andrew, Jo • Acute CPN sp • Physio – Claire • Arrhythmia sp • OT – Dawn & Rachel • Lipid sp • Secretaries – Leanne, Angela, • ACHD sp Louise (HF), Alison (arrhythmia) • Ward team • Consultant • Dietitian - Paul • GP • Pharmacist - Tina • PN • Ph IV team – Audra, Gaz & others • DN • Clinical Psychiatrists – Rob & John • 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, 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????) • Goal setting & modifications • Mobilising resources • Learning – skills, knowledge, beliefs, attitude How • Phone • Assessment, advice, • Visit information, guidance, individual counselling, coaching, • Individual visit listening…. us • Exercise, mobility, activity • Written info 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 • NACR – fitting into a box.