Audit of cardiac rehabilitation in light of the National Service Framework for coronary heart disease

In England, the National Service Framework (NSF) defines a role for clinical audit in cardiac rehabilitation. Areas that audit should consider include: eligibility, recruitment, and patient age, sex and ethnicity. We surveyed cardiac rehabilitation centres to assess these parameters. We contacted 51 centres in 2002. Thirty-three (65%) reported that audit had been undertaken and 24 (47%) were prepared to share information obtained. Reasons for not collecting audit data were lack of time, resources, computing facilities, personnel, training or support. Fifty per cent of audits supplied relied on a 'paper system' with retrospective data extraction, and the others used regularly updated computerised databases. Ninety-one per cent of centres with audit reported information on recruitment but only 43% reported numbers eligible. Information on sex, age and ethnicity was collected by 70-87% of centres but more complete information (adequate for analysis of equity of service use by sex, age and minority ethnic group) was collected by only 30%, 26% and 22% of centres, respectively. In England, cardiac rehabilitation audit data collection is uncoordinated despite the standards set out in the NSF. A national and policy-driven standardised audit tool and appropriate facilities, staff and funding could facilitate the identification of eligible patients and the following of patients through rehabilitation. Audit may help to make certain that local provision of cardiac rehabilitation is inclusive and ensure that patients are attending.