Patient Journey

Traditionally cardiac rehabilitation has fallen into four phases. At The James Cook University Hospital and Friarage Hospital we define the phases as shown below.

Phase I (In-patient phase)

This is the period of time whist in hospital following a heart attack (myocardial infarction), revascularisation (coronary artery bypass graft or coronary angioplasty and stenting) or repair or replacement of aortic/mitral valve.

We understand that not everyone will follow the same route, but during this time the patient and family will receive explanations of their condition and information/education regarding lifestyle. Members of the cardiac rehabilitation team will provide information about the cardiac rehabilitation programmes available to you and depending on the option that you choose you will be given a date to come back to see us in a pre assessment clinic appointment. Depending upon your diagnosis this will be between one and six weeks following discharge as described below:

  • Coronary artery bypass graft surgery/valve – 5-6 weeks
  • Elective/planned coronary angioplasty and stent insertion/percutaneous coronary intervention (PCI) 1-2 weeks
  • Heart attack 1-2 weeks (we aim to see you within 10 days of discharge from hospital)
  • Angina – as soon as possible following diagnosis
  • Heart failure – to be arranged on an individual basis

Pre-assessment appointment

You will be offered a cardiac rehabilitation pre assessment clinic appointment. This appointment usually lasts for about an hour where you will be seen by a cardiac rehabilitation sister / charge nurse and an exercise professional. During this appointment you will have the opportunity to discuss your diagnosis and your individual risk factors for coronary heart disease will be identified, working with you to set goals to help you make any lifestyle changes necessary.

We will also discuss your progress so far, assess our exercise level and address any other concerns you may have. During this appointment we will also discuss your ongoing needs for cardiac rehabilitation and book you onto the most suitable course to meet those needs.

We understand that for a number of reasons attending cardiac rehabilitation clinic/class may not be the best option for you and therefore we can offer different approaches to meet your needs. With support from the cardiac rehabilitation team we can offer a home based cardiac rehabilitation programme using either the heart manual or the South Tees home exercise programme. The heart manual may not be a suitable option following elective (planned) angioplasty and stent or following valve replacement/repair surgery.

Ambulance transport can be provided for you to attend this appointment if you fit the eligibilty criteria. Contact details can be found at the bottom of this page.

Phase II (Immediate post discharge phase)

This is the period of time between leaving hospital and attending your cardiac rehabilitation assessment appointment. Dependent upon the length of time between these you may recieve a phone call from us to check on your progress.

During this time patients are also encouraged all patients to call the cardiac rehabilitation helpline with any questions, worries or concerns they or their family may have.

The James Cook University Hospital – 01642 854644

Friarage Hospital – 01609 764402

Phase III (1 – 6 weeks after the event)

This is the formal exercise programme that you will have chosen following your cardiac rehabilitation pre assessment clinic.

Classes are usually facilitated by a cardiac rehabilitation sister / charge nurse and a cardiac rehabilitation exercise professional, a health care assistant may also be present. We have a number of different courses available so that we can provide rehabilitation programmes to suit all abilities. All courses last for eight weeks and are a combination of exercise, heart related health information, relaxation and support. The eight-week cardiac rehabilitation course is an opportunity for patients to develop a greater understanding of their condition and how they can reduce the risk of further CHD related events occurring.

Gym based circuit
This consists of a gym based circuit with a number of different exercise stations aimed to work all areas of the body and to improve cardiovascular fitness. These classes are available at The James Cook University Hospital and a number of other venues across Middlesbrough, Redcar and Cleveland. Although you have a choice of venues, depending upon your individual needs we may need to signpost you to a specific programme.
Low mobility
The exercise is based mainly on a seated routine and is designed for those who have limited mobility or other conditions that may restrict their ability to exercise effectively in a circuit based exercise. Currently this class is only available at The James Cook University Hospital.
Heart failure management programme
This programme is for patients who have been diagmosed with some forms of heart failure. Patients can access this programme via the cardiac rehabilitation pre assessment clinics or by referral from the Cardiologist or Heart Failure Specialist Nurse. For further details of this programme please click on the link below. Currently this class is only available at The James Cook University Hospital and The Friarage Hospital.

During the cardiac rehabilitation classes a health professional will monitor and record heart rate, blood pressure and rate of perceived exertion (BORG scale). These measurements along with previous test results will enable the team to provide a safe, effective and individual exercise programme.

The above programmes include a comprehensive heart health related education package. Depending on the programme you attend the following  may be covered.

  • Coronary heart disease (CHD)
  • Benefits of exercise
  • Role of cholesterol in CHD
  • Importance of controlling blood pressure in CHD
  • Healthy eating
  • Medicines advice
  • Stress management

We also include an introduction to relaxation throughout the programme.

As well as participating in the structured exercise programme within the cardiac rehabilitation programme we also encourage all patients to increase their level of activity outside of the programme. We have developed a home programme to support this.

Click the links below to download our leaflets

Cardiac rehabilitation exercise programme booklet (250kb)
In order to view PDF documents you will need Adobe PDF Reader

Please note, these documents should be read and used in conjunction with one of the cardiac rehabilitation team members.

Patient transport to The James Cook University Hospital

If you require ambulance transport to bring you to your cardiac rehabilitation clinic appointment or cardiac rehabilitation class the phone number you need to ring is 0345 045 0160

When booking the ambulance please inform the operator that your appointment is in the Cardiac Rehabilitation Department (Bridge entrance 1st floor near ward 30) at James Cook. The booking needs to be made at least two working days prior to the appointment.

If you are attending a cardiac rehabilitation class please inform them that this is a two hour appointment. If you have a one hour clinic appointment a regular drop off time will be long enough.

Please be aware that patient transport services are only able to bring you to James Cook for appointments. They are unable to provide transport to classes at our external venues.

Phase IV (long term maintenance)

Following your cardiac rehabilitation course you may wish to maintain the benefits gained by attending a further exercise programme. The cardiac rehabilitation team have worked closely with the leisure services across the area and our local heart support group to provide safe long term exercise courses. The cardiac rehabilitation team can directly refer you onto these at the end of your initial programme.

For patients attending cardiac rehabilitation following a diagnosis of heart failure long term exercise is provided by us click here for further information.