Our history

Jill’s recollection of the establishment of the Cardiac Rehab programme in Wales

I was a newly qualified staff nurse on the Coronary Care Unit in 1983 in Newport’s Royal Gwent Hospital. While working there it was becoming increasingly obvious to me that although patients who had experienced a heart attack received excellent treatment, they were not getting enough continued support once they had received their initial treatment. There were new things in development such as medication but rehabilitation for cardiac patients was in its infancy in the UK and not even in existence in Wales.

Jill at the start of her Cardiac Rehab journey!

There seemed to be very little aspiration that cardiac patients could regain their full quality of life or even for some patients that they could have the potential, through lifestyle changes to be in a fitter state than before their treatment.  To suggest this at the time seemed out of this world and to give an example,  historical advice included not only staying in bed but also bringing those beds downstairs!

Even for those patients that would have to accept that their heart attack had left them with physical limitations, I always felt that good rehabilitation support could help patients to find a new joy in things that they may have previously taken for granted. Such as the joy of walking in nature and taking in the scenery or finding a new hobby or making quality time for family and friends.

I decided to look into what a rehabilitation programme could offer and discovered that St. Georges Hospital in London were pioneering a multi-disciplinary approach. They had realised that there was no ‘silver bullet’ following initial treatment and that recovery very much depended on the patient themselves. The visit to St Georges was a real revelation –  it was the first time I had encountered a multi-disciplinary Cardiac rehab team made up of a physio, occupational therapist and nurse – enabling patients to return to exercise. Not only that but recovering patients also had access to advice from a dietician and counselling on giving up smoking. The improvement in the patients really sold it to me as I was seeing the difference this joined-up approach was making to their recovery. Armed with all this information I wanted to bring it to Wales.  I approached Dr John Davies who was our first Consultant Cardiologist at the Royal Gwent, and he was very enthusiastic and supportive. I was very lucky that Dr Davies was so encouraging.  He was a great advocate for what cardiac rehabilitation could offer and was the first consultant to refer patients to the programme.  He always went out of his way to promote the service to other consultants and invited me to speak about the service at conferences and seminars.  Dr Davies was very well thought of by his patients and was such a great supporter in those early days. (If you would like to learn more about Dr. John Davies, here is a link to his obituary John Davies | RCP Museum | rcplondon.ac.uk).

It was vital that establishing the service also had the full support from the senior management at the hospital. I spoke to Mrs Hazel Taylor (Matron) who also supported the idea and was very encouraging but pointed out that there was no funding available at that time for new services. I immediately volunteered to look into raising the funds to develop the cardiac rehabilitation  programme. Mrs Taylor agreed that if I were successful then we could get together and talk again…

All I needed now was some expertise in fundraising!  At the time, I was extremely lucky that Gaynor Colbourne was the Clerk on our Coronary Care Unit. Gaynor was very welcoming when I joined the  Unit in 1983 and was immediately supportive of the idea of starting a cardiac rehabilitation Programme. Gaynor spoke to her husband Ron who already had fund raising experience and they both enthusiastically offered to fundraise! We needed to get enough money to get the ball rolling as soon as possible and we initially set ourselves a target of a year. Gaynor and Ron brought a small group of us together and organised a whole host of fund raising activities.  Thanks to Ron and Gaynor’s dedication we developed into very efficient fundraisers!  They formed us into a proper fundraising Committee with Ron as our Chair, Gaynor as our Treasurer and Gill Rogers as the Secretary. Other early members were Liz & Bryn Williams and Audrey Adams with Mr David Turnbull as our first honorary President, followed by Dr John Davies. We tirelessly attended local shows, held sponsored events, raffles and many other activities (read Gaynor’s Story) to raise enough funds until finally, we were able to go back to the Matron, Mrs Taylor, and say: ‘We’ve got the money!’  True to her word, Matron agreed that we could go ahead to establish a new cardiac rehab programme.

The Nursing Officer at the time was Mr Geraint Morgan who was very encouraging and supportive. The first multidisciplinary members to join the cardiac rehab team were; Physiotherapist Jackie Fleet, Occupational Therapist Margaret McKie, Pharmacist Mike Curson, Dietician Jayne Lavin, nurse Annie Flower (previously Evans) and myself.

As the word got around about the success of the programme and consultants `began to get  on board’. There remained only one consultant who was initially very hesitant.  A patient referred to this particular consultant saw that other patients were benefitting and wanted to be part of our new programme. I duly asked the consultant if they would consider his referral to our programme of activities to which their response was a reluctant ‘yes’, followed by ‘if anything goes wrong you won’t have any more referrals from me’! We really hoped that the patient, would turn out to be a model patient in order for us to convince our sceptical consultant!  I am pleased to say that he certainly was.  With the support of the programme, he gave up smoking, lost weight, began regular exercise and learnt how to better manage stress.  He returned to work and made an excellent recovery.

As the service developed Nurse Jean Hughson pioneered its establishment in Torfaen at County Hospital.  Jean went on to set up a new ‘Heartline’ phone answering service. This filled a gap as people were only just getting mobile phones and most people did not have their own computer for checking information via the Internet. Volunteers were recruited to operate the new telephone helpline which meant we could refer people to the helpline with any queries. Our volunteer ‘recruits’ were beneficiaries of the Cardiac Rehab Programme and were in an excellent position to empathise with the people ringing and provide a valuable listening ear.  Clinical queries were referred on to the nurses.  Heartline was soon followed by ‘Heart call’ ex patients who were volunteers were carefully selected and offered training to enable them to visit recovering patients in their own homes providing a listening ear over a cup of tea  and even accompanying them on their walks to help the new patients regain their confidence and fitness. This was groundbreaking work and Jean was joined by dedicated nurse Sue Francombe and colleagues from physiotherapy and other members of the multidisciplinary team.

At the time, the cardiac rehabilitation programme and its approach were considered innovative and groundbreaking and as a result, it was awarded the prestigious ‘Charter Mark’. Nurse Jean Hughson and I went to London on behalf of the team to receive the award and to us this was finally ‘official recognition’ for the work that the Cardiac Rehab team were undertaking. It was very rewarding to see that starting from very humble beginnings, we were now able to show that as a result of our rehabilitation service, cardiac patients were physically and mentally improving post treatment.

As the service developed we were able to expand to other areas including Caldicot and Caerphilly. In the early days other nursing staff to join the team included Angela Knott, Eileen Knight and Eileen Symonds. Experienced medical and cardiac nurses who were all passionate about improving patient care.

Meanwhile, Ron and Gay Colbourne’s continued dedication to organising fund raising activities meant that we were able to offer new equipment for our patients and education for our staff – which did not (and still does not) come cheap! At the time, there were very few or no relevant educational courses for the team to attend.  This lead us to host our own conferences and educational events which people travelled from all over Wales and beyond to attend.

Although we were seeing encouraging results from the cardiac rehabilitation programme, it became clear that once patients had completed the 6 week hospital based programme, many of them wanted to continue to exercise in a community based class. We needed community based classes as quickly as possible. Caroline Watts was a Health Promotion Officer who was the first to establish a Community Cardiac Rehab Class at Lliswerry Leisure Centre in Newport.  This was a major development as it was not a ‘thing’ then to have patient rehabilitation exercise classes outside of the hospital setting.  Caroline was followed by a number of other innovative, pioneering exercise tutors including; Greta Hart, Andrea Jones, Brenda Cook and Yvonne Silver. As cardiac rehabilitation became more established and a recognised part of the care for cardiac patients specialised training for delivery of these Community Classes was required. This was a challenge as the correct certification was needed, which was expensive – but we needed future classes to have tutors that were properly qualified to deliver them – so it is great that today we can continue to fund this training for Community Tutors.

Overall, it was clear that we needed to make the wider community aware of our programme and its benefits. We continued to fundraise and raise awareness through giving talks and presentations. I eventually ended up on the Rotary Club Circuit, talking about the Cardiac Rehab Clinic and the Fund and talks about our programme were suggested to other groups. This of course was wonderful because as well as spreading the word about cardiac rehabilitation some of those groups would go on to fundraise for us, especially as we were a small and very local charity. Very often we would get a speaker’s fee, around £10 and then receive a follow-up phone call saying; ‘We’d like to organise a sponsored walk for your charity’!

We enjoyed talking about our work in order to help the service. The first time I went to a Rotary Club meeting I felt very daunted, even overwhelmed! They were all men, and it was very formal, complete with a real deference to the speaker! I remember at one particular meeting, one of the members had benefitted from the Service and therefore was very keen to fundraise for us.

The talk circuit grew with invitations from the extensive WI (Women’s Institute) circuit, different men’s groups, all sorts of organisations including Pill Harriers and Llanwern Steel. Ron, our Chairman worked at the Steel Works at Llanwern, and we were very grateful to benefit from their charity pot!

A great deal of our funding came from donations from grateful patients and even the children of these patients’ running marathons to help us. We were raising enough to not only maintain the service but to expand it too! We were incredibly fortunate with the support for our regular Carol Singing events and annual Sponsored Walk along the Mon Brecon Canal. In the early days this was a pretty rough walking route and on the first walk I had my baby daughter, Christie in a very robust Silver Cross pram, ploughing through the mud – it was a miracle I didn’t lose my daughter in the canal!  The sponsored walk was an annual event for years and my now grown-up daughter found herself pushing her own daughter in a pram on the same route! The walk continued right up until the pandemic, raising money for the Fund for over thirty-five years!

Jill (right) with Cardiac Rehabilitation nurse Ceri Kostin at the recent ‘Cardiac Rehabilitation: A patient’s journey’ conference at the Pierhead Building, Cardiff Bay.

The Cardiac Rehab Service and Fund Raising Trust will always be very much a family affair, husbands, wives, partners, and children are great supporters.  They know how much it means to us  and are alongside us every step of the way.  Sadly, our Chairman Ron passed away a few years ago but I know that he would be enormously proud that the work that he and his wife Gaynor started all those years ago has continued to go from strength to strength and that our Cardiac Rehab programme, which started off in Newport, is now accepted and replicated all over Wales and the UK.  I feel very lucky to have worked with such great patients, their families and staff.

The research evidence that wasn’t available in those early days is now clear that cardiac rehab programmes help patients’ recovery and quality of life. What a privilege to have been a part of this.