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National Audit of Cardiac Rehabilitation

The National Audit of Cardiac Rehabilitation (NACR) collects comprehensive audit data to support the monitoring and improvement of cardiovascular prevention and rehabilitation services in terms of access, equity in provision, quality and clinical outcomes.

What does it measure

The NACR dataset can be found under user registration and guidance.


Cardiovascular prevention and rehabilitation services are a vital part of the care pathway for patients with heart disease. It is an evidence based intervention which reduces future mortality and morbidity, is cost effective and is recommended by many national and international guidelines. It should be available to everyone with heart disease, but not all patients are offered the chance to take part.

The NACR aims to increase the availability and uptake of cardiovascular prevention and rehabilitation, promote best practice and improve service quality in cardiovascular prevention and rehabilitation services by:

  • informing local and national planners, providers and commissioners where services are not reaching expected standards as defined in key national guidance.
  • identifying inequitable provision so that local providers of cardiac rehabilitation can formulate appropriate business plans and work towards all patients having an equal opportunity to benefit.
  • describing the typical gains that a patient can expect from cardiac rehabilitation against which the effectiveness of individual programmes can be judged.
  • examining reasons for variation in patient outcomes between programmes, so that services can be helped to improve.
  • sharing national trend data with appropriate national bodies including the Department of Health, NHS England, National Institute for Clinical Excellence (NICE), Cardiovascular Care Partnership UK and the British Association for Cardiovascular Prevention & Rehabilitation (BACPR).

Who manages the audit

Established in 2005, NACR is managed by a team based in the Department of Health Sciences at the University of York. Informatics and data management services are provided by NHS England.

How is data collected

Submission of data by programmes on their individual patients

Information on medical history, demographics, smoking, physical activity and mental and physical well-being is entered manually into the NACR through a secure online portal, provided by NHS England. Alternatively, data files of records for multiple patients are uploaded.

Data is gathered by clinicians and by purpose-designed questionnaires. Patients complete a questionnaire before, immediately after and 12 months after attending rehabilitation. The staff of the programmes distribute the questionnaires themselves, receive the replies, and submit the data to the NACR Database.

The York team use the data to produce annual reports and ad hoc reports by request for individual programmes. Programmes can also view and download their data for local analyses.

An annual postal survey of programmes

The survey collects information on organisational elements such as staffing and activity. The NACR team at York send questionnaires out to the co-ordinators of every cardiovascular prevention and rehabilitation service on the register they maintain, receive the responses, collate the results and include them in the project's annual reports.


Data is also collected to enable the audit to be sensitive to changes in clinical practice.

How to participate

Further details about the NACR can be found on the NACR website. You can find out how to register your interest and how to participate.

Publication of the audit results

An annual report is planned for November

For further information about publications and submission deadlines, please visit the NACR website.

User registration and guidance

Last edited: 20 September 2023 3:13 pm