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Aseptika’s Active+me REMOTE for Cardiac Rehabilitation Funded by Innovate UK

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After a life-changing event, such as a heart attack or bypass surgery, the NHS can provide many patients with cardiac rehabilitation programmes. This reduces the risk of death and future heart attacks and improves the quality of life for patients. However, only about half of those invited attend these NHS group-based programmes.

During the pandemic, many NHS cardiac rehabilitation (CR) services were moved online and saw an increase in patient uptake.

Now that in-person NHS cardiac rehabilitation services have restarted, there are increased pressures within healthcare: backlogs of people waiting, hospital gym facilities co-opted for other services or staff still returning from redeployment (against a backdrop of 7.2 million patients waiting for NHS care and a shortage of 110,000 staff).

Every in-person encounter between a patient and clinical staff is of great value (and cost). These can be made more impactful through the use of digitally delivered services, especially when provided in the patient's own home, saving time, money, reduction of carbon emissions and allowing working patients to attend at a more convenient time for them.

The NHS Long Term Plan[i] has the goal of increasing the number of eligible patients joining cardiac rehabilitation after a heart event from 50% to 85%.

Co-funded by Innovate UK, Aseptika is collaborating with the University of Birmingham, University of York and the National Audit of Cardiac Rehabilitation (NACR) to study the impact of a hybrid delivery of cardiac rehabilitation, which combines the best of in-person coaching, remote monitoring and patient education and support, in a new way of delivering this life-changing programme.

Professor Kate Jolly, Professor of Public Health & Primary Care at the Institute of Applied Health Research, University of Birmingham is leading the evaluation of the Aseptika system by using information that is routinely collected in an anonymised form by the NACR, which is a large database funded for use by the NHS throughout the UK.

Professor Jolly said: “This research project aims to explore new ways in which digitally delivered healthcare is tested with patients without the costs and long timelines associated with traditional clinical trials that can take many years to conduct. We will use anonymised data reported to the NACR to find out whether more patients take-up hybrid rehabilitation and whether the expected improvements in quality of life are seen, compared with pre-pandemic services which previously mainly offered in-person group-based delivery.”

The potential cost savings will be researched by Sebastian Hinde, a Research Fellow at the Centre for Health Economics at the University of York. “Understanding why patients do not take-up their place on the eight-week programme of cardiac rehabilitation is a complex issue. Many groups within society suffer health inequalities because they may have to return to work or live in isolated areas, are unable to afford transport, are themselves caring for a relative, do not have English as their first language or do not like exercising in mixed sex classes. We already know that the cost of reaching the “next 35%” of patients who suffer from health inequalities is going to be higher. We expect that this study will show how delivery using technology and through in-person contact with patients can help the NHS achieve its long term plan.”

Active+me REMOTE for Cardiac Rehabilitation is already in use by the NHS in several hospitals. To support implementation and the hybrid delivery, funding from Innovate UK has supported Aseptika to hire a Cardiac Rehabilitation trainer to help NHS staff get the technology out to more patients.

Bernadette Gipson has joined Aseptika as the company’s Healthcare Services Support Manager from the public health sector and is qualified to deliver Cardiac Rehabilitation classes to Phase IV. “I am in awe of the technology the team at Aseptika has developed for Cardiac and Pulmonary rehabilitation. I will be directly supporting the NHS Cardiac Rehabilitation leads in the delivery of hybrid services and aim to reach as many patients as possible. Having delivered Cardiac Rehabilitation classes in the Peterborough area, I am keenly aware of the impact of rural isolation, poverty and the barriers to service access that many patients encounter, so I am excited to join Aseptika and to work alongside and support the NHS Cardiac Rehabilitation professionals in this new way of delivering this service.”

The 18-month project will result in a number of reports and joint publications to give feedback to the NHS and aims to reach up to 500 patients and follows a positive trial with Addenbrookes Hospital during the COVID-19 pandemic supported by Eastern Academic Health Sciences Network (EAHSN) and Innovate UK2.

1NHS Long-Term Plan. https://www.longtermplan.nhs.uk/publication/nhs-long-term-plan/

2Changes in patient activation following cardiac rehabilitation using the Activeme digital healthcare platform during the COVID-19 pandemic: a cohort evaluation. BMC Health Serv Res 21, 1363 (2021). Gabbi Frith, Kathryn Carver, Sarah Curry, Alan Darby, Anna Sydes, Stephen Symonds, Katrina Wilson, Gordon McGregor, Kevin Auton & Simon Nichols.