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Background Cardiac Rehabilitation (CR) significantly reduces the risk of cardiovascular mortality and hospitalisations. Despite this, the RDE CR service is underfunded, understaffed, and currently on the trust’s risk register. Local evidence is required to support its value and justify further investment.Aim To compare mortality and hospitalisation rates in RDE patients who participated in CR versus those who did not, over a minimum 22-month follow-up period.Methods Patients within the RDE CR catchment area with an eligible admission between 1/1/2023 and 30/6/2023 were identified. Patients who died within two months of admission were excluded. The first 100 patients from each of four categories were included: 1) Gym-based CR, 2) Home-based CR, 3) Phase 2 CR input (but not full programme), and 4) Not referred due to local exclusion criteria. Manual review of patient records extracted data on all-cause unplanned hospital readmissions and deaths from the date of eligible admission to 30/4/2025.Results Unplanned Hospital Readmissions, Hospitalisation Days, and Survival by Group Group All-Cause Readmissions (%) Cardiac-Specific Readmissions (%) Unplanned Hospitalisation Days Survival by April 30, 2025 (%) Group 1 (CR) 31% 24% 252 99% Group 2 (CR) 37% 23% 291 100% Group 3 (CR) 42% 25% 506 92% Group 4 (No CR) 53% 36% 742 90% Key Findings All-cause unplanned hospital readmissions were 16% lower in CR groups (average 37%) vs. no-CR (53%).Cardiac-specific unplanned readmissions were 12% lower in CR groups (average 24%) vs. no-CR (36%).Unplanned hospitalisation days were over 50% lower in CR groups (average 350) vs. no-CR (742).Survival by April 30, 2025 was higher in CR groups (average 97%) vs. no-CR (90%), a 7% absolute survival benefit.Conclusion This local study confirms that CR significantly improves patient outcomes, with fewer readmissions, shorter hospital stays, and higher survival rates. The findings provide robust local evidence to support increased trust investment in the RDE CR service.