Barriers to accessing cardiac rehabilitation services Angela Tod Research Fellow South Yorkshire Coalfields Health Action Zone School of Nursing and Midwifery, University of Sheffield a.tod@sheffield.ac.uk 0114-2229775 20/11/2018

What is Recovery? What is recovery? Different person (+ / –) Adjustment and acceptance How do patients know when they have arrived or not? Control Confidence Informed Look to the future Trusting the body Recovery / coping mechanisms needed to achieve recovery? Seek understanding Reprioritise Compare to others Resume activities Set new targets Accept / redefine limits Attributions & explanations e.g. age, tablets, life course 20/11/2018

What service is needed to facilitate recovery? What did people require from the service in order to help them them mobilize their recovery / coping mechanisms and to move along the pathway to recovery? Nature of the service: continuity, individualized: Listening Taking time Personalized information and care Content of the service: explanations, someone to talk to, home visit, assessment/monitoring, meeting others in the same position Staff attitude: honesty, knowledgeable, reassuring, caring 20/11/2018

Key messages Importance of: Need for service redesign planning & investment structure and capacity to prevent delay and barriers to access processes to support care and communication across the pathway social and cultural influences on recovery and service access Need for service redesign primary care based assessment / triage individualized care 20/11/2018