Rehabilitation is a key part of heart care

The Healthcare Commission quizzed nearly 4,000 heart patients who attended NHS trusts across England.

Many said they left hospital without basic advice about diet and exercise.

And 63% - including nearly half of heart attack patients - said they had not taken part in a cardiac rehabilitation programme.

It is essential that measurements are set in place to ensure that trusts are meeting heart patients' needs Anna Walker

Four out 10 who were smokers said they had not been given information on specialist services to help them quit.

A Healthcare Commission report on coronary heart disease, published earlier this year, highlighted that many improvements have been made.

Patients are getting treatment more quickly and death rates are coming down.

But chief executive Anna Walker said a similar focus was needed to drive up standards of rehabilitation and aftercare.

Measures required

She said: "It is very concerning indeed that some heart patients are reporting to us that they are not getting the advice and aftercare they need to recover as fully as possible and enjoy the best possible quality of life.

"It is essential that measurements are set in place to ensure that trusts are meeting heart patients' needs for rehabilitation and ongoing preventive care in order to make a full recovery."

The Healthcare Commission called for immediate improvements in access to cardiac rehabilitation services.

It said this can be achieved through increasing the numbers of places available, by moving services closer to patients, and increasing the choices patients can make about the content of rehabilitation programmes.

The Commission also said hospitals need to make sure they are identifying all patients who might benefit from rehabilitation and referring them on.

It was also important to make sure that advice on lifestyle changes - diet, exercise and smoking - was given to all patients before being discharged from hospital.

Big killer

Heart disease is the biggest cause of death in the UK, killing over 110,000 people a year. But death rates are coming down.

The Healthcare Commission is to conduct and publish a review of services for treating heart failure.

It also plans to consult on new annual performance indicators.

Steve Shaffelburg, of the British Heart Foundation, backed the findings of the study.

He said: "Although there are more than 350 cardiac rehabilitation programmes in the UK, many of which are excellent, provision is patchy and in some areas, patients have very poor access to these services."

Health minister Rosie Winterton said: "We know that high standard rehabilitation services are not yet consistently available throughout the country.

"Improving rehabilitation services for heart patients will be a major focus of the next phase of service improvement."