GB-UKPRN-10007794-ACROSS University of Glasgow The combination of heart disease alongside depression and anxiety is a common and profound unmet need for global health systems, especially in low and middle-income country settings. It affects people of working age causing them major financial loss (& other long-term conditions) that further adds to their ill-health. Rehabilitation, ‘the action of restoring someone to health or normal life after illness’ is recommended by the WHO as a core component of health services. Rehabilitation includes exercise, education, and psychological support. It has proved to reduce death rate and hospital admissions and improve the quality of life and mental well-being. However, due to financial limitations and lack of appropriately trained health care personnel, the availability of rehabilitation services in low- and middle-income countries is virtually absent. Therefore, there is an urgent need to develop an affordable model of rehabilitation that can meet the huge unmet health and socioeconomic needs of people with multiple long term conditions that include both heart disease and mental health disorders. Working with partners in Bangladesh and Pakistan, the ‘Affordable Cardiac Rehabilitation: an outreach Inter-disciplinary Strategic Study’ (ACROSS) programme seeks to develop and evaluate the implementation of a clinically effective, affordable, and culturally and contextually appropriate model of home-based rehabilitation. ACROSS has four work packages: (1)Engagement events with those with lived disease experience, their families, healthcare staff, and service providers will assist us to co-develop a culturally and contextually adapted home-based rehabilitation ('ACROSS') programme and training materials for providers; (2) A pilot study will allow us to understand if the ACROSS programme is acceptable and practical for patients and staff and whether a full scale trial is doable; (3) A trial in 2000 patients with multiple long-term conditions that include heart disease and depression and anxiety across several sites in each country will tell us whether the programme improves their health outcomes at 12-months and what is its affordability; and (4) Develop a sustainable model of workforce training and implementation to enable long-term programme delivery as well as build partner future research capacity. University of Manchester University of Leicester Ishrat Husain Pakistan Institute of Living and Learning (PILL) Bangladesh University of Health Sciences UK - Department of Health and Social Care (DHSC) University of Glasgow Official start date when contract was signed with NIHR University of Glasgow School of Health and Wellbeing David Innes Global ACROSS Project Manager David.Innes@glasgow.ac.uk 505043 1001061 879561 847913 808565 43264.00 101292.02 199999.99 99999.98 2798.40 ACROSS University of Leicester expenditure July 2025 - December 2025 43867.66 ACROSS PILL expenditure October 2025 - December 2025 27508.39 ACROSS PILL expenditure July 2025 - September 2025 38934.00 ACROSS BUHS expenditure July 2025 - December 2025 72968 ACROSS programme running costs July 2025 - September 2025 59296 ACROSS programme running costs October 2025 - December 2025 59998 ACROSS programme running costs January 2026 - March 2026