I propose to take Questions Nos. 487 and 488 together.
Cardiac rehabilitation (CR) is a core component of secondary prevention for patients with heart disease, supported by a strong and extensive evidence base demonstrating its effectiveness in improving outcomes for patients. Its importance was recognised in Changing Cardiovascular Health 2010–2019 and further emphasised in the recently published National Review of Specialist Cardiac Services.
The Model of Care for Integrated Cardiac Rehabilitation, launched in October 2023, aims to ensure that all patients living with cardiovascular disease (CVD) have equitable, timely access to high-quality CR services, regardless of where they live. For individuals hospitalised with CVD, preventing further cardiac events and avoidable readmissions is critical. The model of care acknowledges that optimising outcomes for patients requires increased focus on recruitment and retention, and that offering flexible modes of participation is essential to meeting patient need. The development of the national Model of Care for Integrated Cardiac Rehabilitation is a step forward in that it will facilitate patients living with cardiovascular disease across the country have access to timely high quality cardiac rehabilitation care.
To support implementation of the Model of Care for Integrated Cardiac Rehabilitation (MoC CR), an in-depth understanding of current hospital and community services (hubs) was identified as a requirement. To this end, a structured overview of hospital and hub-based CR sites was completed. The aim of the overview was to identify the resources, supports and training needs required in order to advance implementation of the MoC CR nationally. This report was published in 2025 - An Overview of Cardiac Rehabilitation Services in Ireland.
Recommendation 19 of the National Review of Cardiac Services 2023 (NRCS), published in April 2025, sets out that all patients, following a cardiac event, or those diagnosed with HF, should be offered and have access to an appropriate CR programme.
As part of the NRCS implementation prioritisation, funding was provided through the HSE National Service Plan 2025 to support the project, Implementation and evaluation of the MoC CR. This proof of concept, addressing critical gaps in CR teams in two Integrated Health Areas, in HSE West & North West, by recruiting the deficit posts, to convene complete integrated CR teams, and subsequently enabling these teams to deliver and evaluate an end-to-end implementation of the MoC CR is underway.
The objectives of this project are to deliver a timely, high quality, equitable, person-centred CR service, while offering patient choice and access to a standardised CR programme and reduce waiting times. Learnings will be shared across all six health regions.
In addition, in 2025, the HSE funded the development of a National Clinical Action Guide for Delivery of Integrated Cardiac Rehabilitation. The service overview report highlighted a lack of standardisation in delivery of CR across the country. The Clinical Action Guide will address this recommendation and support delivery of high quality, person-centred, evidenced-based CR.
Cardiovascular health was a key pillar of the investment announced in Budget 2025 which provided more than €9 million in full-year funding for cardiovascular initiatives, including €4 million and 45 posts dedicated to cardiac services To date, 28 of these 45 WTEs have been prioritised. This investment facilitates the initial steps in cardiac services reform and will support the development of a new cardiovascular strategy as committed to in the Programme for Government. In the short term, we will deliver enhanced cardiac services and develop the necessary structures to ensure success in the longer term.
From 2026 onwards, the HSE’s planning framework will centre on region led operational planning. As outlined in the HSE National Service Plan 2026, a key priority action for the HSE is to progress the implementation of the National Review of Cardiac Services 2023, including the strengthening and expansion of Cardiac Rehabilitation services.
