Background Over a million people in the UK live with heart failure (HF) (British Heart Foundation. UK factsheet. January 2024). The National Institute for Health and Care Excellence (NICE) recommends personalised exercise-based rehabilitation, in accessible settings, including psychological support and assessment of palliative care needs (NICE. Chronic heart failure in adults: diagnosis and management. [NG106] 12 Sept 2018), previously unavailable in our area. We are the first hospice piloting Rehabilitation Enablement in Chronic Heart Failure (REACH-HF), an evidence based (Dalal, Taylor, Jolly, et al. Eur J Prev Cardiol. 2019;26(3):262–272) NICE recommended (REACH-HF delivery guide) 12-week programme of HF rehabilitation, which encourages caregiver participation.

Aims Enable heart failure self-management to improve quality and quantity of life. Reduce admissions, support advance care planning, and introduce hospice services to patients, relatives, and cardiology colleagues. Improve collaboration, increase referrals, and upskill hospice staff in supporting heart failure patients.

Actions/Methods Our Integrated Care Board funded two staff members for REACH-HF facilitator training. REACH-HF was delivered to 25 patients in 12 months. Patients had face-to-face contacts with a facilitator before and after the programme, with weekly or fortnightly phone contacts, and home visits when needed. Results were audited using timed up and go (TUG) and modified sit to stand (STS) outcome measures, palliative outcome score (POS) and a modified Views on Care (VOC) questionnaire.

Results Patients reported better self-management and would access hospice services in the future.

TUG, STS, POS showed physical improvements, whilst POS and VOC showed mental benefits and goals achieved: ‘I learnt to relax and be more realistic’ and ‘I fished on holiday’.

Both facilitators gained confidence in rehabilitating HF patients, improving delivery of other courses.

Improved links were forged between teams, increasing referrals. The new community heart failure team is commissioning further hospice REACH-HF support, and more hospice staff intend to become REACH-HF facilitators.

Conclusion Delivery of REACH-HF by hospice staff has measurably benefited patients, complemented existing services, broken down barriers and improved access to hospice services for heart failure patients.