Cardiac Rehabilitation

   NHS National Audit of Cardiac Rehabilitation

NHS Digital


BACPR/NACR Certification


The National Certification Programme for Cardiac Rehabilitation (NCP_CR) is a joint project between the BACPR and NACR that has been running for nearly four years. Since 2018, certification standards for all programmes in England, Northern Ireland and Wales have been reported as part of the NACR Quality and Outcomes Report.

What does 'minimum standard' mean?

The updated BACPR Standards & Core Components were published in 2017, and represent agreed national standards for the delivery of CR in the UK. Over the past few years, there has been a growing emphasis on quality assurance of services across the NHS. However, through NACR data analyses and published research it's clear that around a quarter of cardiovascular disease prevention and rehabilitation programmes in the UK meet quality standards with others at less than optimal levels service delivery.

The NCP_CR, Steering Group strives to make the certification process: easy to access, attainable and ensure the process is equitable. Before any programme can be assessed against NCP_CR Key Performance Indicators they must be entering data into the National Audit for Cardiac Rehabilitation (NACR).

The KPIs (below) are based on NCP_CR agreed standards that are informed by the BACPR Standards and Core Components (2017). Certification is achieved through meeting all 7 KPIs:

3 Minimum Standards (1-3) and 4 Standards based on national averages.

Key performance indicators (KPIs)

Minimum standard 1: MDT

At least three health professions in the CR team who formally and regularly support the CR programme

Minimum standard 2: Patient group

Cardiovascular rehabilitation is offered to all these priority groups: MI, MI+PCI, PCI, CABG, Heart Failure

Minimum standard 3: Duration

Duration of Core CR programme: > national median of 56 days.

Standard 4: National average for assessment 1

Percent of patients with recorded assessment 1: > England 80%; Northern Ireland 88%; Wales 68%

Standard 5: National average for CABG wait time

Time from post-discharge referral to start of Core CR programme for CABG: < national median of England 46 days, Northern Ireland 52 days, Wales 42 days

Standard 6: National average for MI/PCI wait time

Time from post-discharge referral to start of Core CR programme for MI/PCI: ? national median of England 33 days, Northern Ireland 40 days, Wales 26 days

Standard 7: National average for assessment 2

Percent of patients with recorded assessment 2 (end of CR): > England 57%, Northern Ireland 61%, Wales 43%

* Information on staffing profile and MDT is taken from the NACR annual paper survey sent out each year by NACR team. This information is not available from the electronic NACR database. In order for certification to be validated each CR team must return the NACR annual paper survey form with staffing detail sections completed.

The NACR Quality and Outcomes Report ( shows a full list of all registered CR programmes:

Green: Meeting all 7 minimum standards ('certified')

Amber: Meeting 4-6 minimum standards

Red: Meeting 1-3 minimum standards

Fail: Meeting 0 standards or not entering data on NACR

and this list will be updated on an annual basis.

NCP_CR quality appraisal is an annual process meaning that each year there will be an updated version of the extent by which programmes meet the KPIs and their certification status. All current certification will finish on publication of the next NACR Quality and Outcomes Report at which point all confirmed certified sites will be informed of their new status. For current list of certified sites please click here. If you have any queries regarding your programme's NACR data, please contact Nerina Onion (

 The University of York