q&a Dr Hugh Bethell
Dr Hugh Bethell took cardiac rehabilitation to a new level with a groundbreaking facility, the Basingstoke and Alton Cardiac Rehab Centre, which for more than 30 years has been helping heart disease patients return to a full and active life. He talks to Kath Hudson
What is the Basingstoke and Alton Cardiac Rehab Centre? We have two gyms, an exercise testing room and a lecture theatre and we treat over 500 heart disease patients a year, giving them a 12-week exercise programme. Patients admitted to the Basingstoke coronary care unit are
visited before discharge and invited to join the programme. Local patients who are treated by heart surgery or angioplasty are also automatically recruited. In addition, we get referrals from GPs and other hospital consultants from further afi eld. At the end of the programme, they can either stay with us
or move on to exercise elsewhere. We also offer education on issues such as nutrition, risk factors, stress management and relaxation – the programme has become much more comprehensive as time has gone on. We built the current centre in 1997 after outgrowing our original sports centre facility.
What sort of fitness programme do you prescribe? It’s natural to feel wary after having a heart attack, and we want to give people back their confidence to exercise. We give customers an initial consultation, including history and examination, followed by a treadmill exercise test before prescribing a programme focused on their needs. They are asked to do three sessions a week: two in the centre under supervision and one at home. At 10 to 12 weeks, they are re-tested and, provided they have achieved a certain level of fitness, can then go on to exercise unsupervised.
What was the inspiration for the centre? I qualified as a doctor in 1966 and worked in hospitals for eight years. During that time, I worked as a cardiac registrar at Charing Cross hospital in London with Peter Nixon, the first British cardiologist to seriously take on-board the idea
In 2000, no more than 30 per cent of eligible patients in
the UK had access to cardiac rehabilitation programmes
48
that exercise could aid the recovery from heart disease. Until then, people considered their active life over after a heart attack. In 1974, I moved into general practice,
which was when I approached a local sports centre about integrating the treatment of heart disease patients into the exercising population. In 1976, we opened the fi rst cardiac rehab centre in a community sports centre. In the fi rst couple of years, we only had 20 or 30 patients, but then in 1978 I approached the Basingstoke District Hospital and it quickly gathered momentum.
What challenges did you face in setting the centre up? Remarkably few to be honest. Both the sports centre and the cardiologist at the hospital were very open-minded and supportive of the idea, so there was no resistance. The main problem over the years has been to get adequate funding.
So how is it funded? Initially we ran our services voluntarily, and the sports centre charged a small fee, but as time went on we applied to the hospital for payment for staff costs. I think the average cost to the hospital for each person is now around £300. Much of the running costs are paid by the Basingstoke &
Alton Cardiac Rehabilitation Charity, which was set up in 1992 – users are only charged a minimal cost of around £1.50 per session. We raise £200,000 a year to run the centre and get half of this back from graduates of the programme, who stay and exercise with us after they have fi nished the supervised sessions.
What’s your day-to-day role at the centre? I’m now retired, so I don’t have a paid role, but I run the research programme and am the overall lead for the Staywell Programme. I’m also secretary to the trustees who oversee the charity.
What is the Staywell Programme? This is designed to catch people who are at risk before they have a heart attack – for example, those with diabetes or high
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