OBJECTIVES: To determine why so few patients with chronic heart failure in England, Wales, and Northern Ireland take part in cardiac rehabilitation. DESIGN: Two-stage, postal questionnaire-based, national survey. PARTICIPANTS AND SETTING: Stage 1: 277 cardiac rehabilitation centres in England, Wales, and Northern Ireland registered on the National Audit of Cardiac Rehabilitation register in 2009–10. Stage 2: 35 centres that indicated in stage 1 that they provide a separate cardiac rehabilitation programme for patients with heart failure. RESULTS: Full data were available for 224/277 (81%) cardiac rehabilitation centres. Only 90/224 (40%) routinely offered phase 3 cardiac rehabilitation to patients with heart failure. Of these 90 centres that offered rehabilitation, 43% did so only when heart failure was secondary to myocardial infarction or revascularisation. Less than half (39%) had a specific rehabilitation programme for heart failure. Of those not providing for patients with heart failure, 134/224 (60%) considered a lack of resources and 89/224 (40%) exclusion from commissioning contracts as the reason for not recruiting patients with heart failure. Overall, only 35/224 (16%) centres provided a separate rehabilitation programme for people with heart failure. CONCLUSION: Patients with heart failure as a primary diagnosis are excluded from most cardiac rehabilitation programmes in England, Wales, and Northern Ireland. A lack of resources and direct exclusion from local commissioning agreements are the main barriers for not offering rehabilitation to patients with heart failure.