Taskforce policy paper to support the improvement of pulmonary rehabilitation services
Pulmonary rehabilitation (PR) is an exercise and education programme, specifically tailored to individuals – this intervention is highly effective for many people with long-term lung conditions, helping people stay active. It combines information on looking after the body and lungs, advice on managing symptoms – including feeling short of breath – nutrition advice, psychological support and stop smoking advice.
However, throughout the COVID-19 pandemic, demand for PR increased as many services were forced to pause, resulting in backlogs in care. Similarly, without access to PR, some people with lung disease deconditioned, and a new group of people experiencing Long COVID-related breathlessness were also referred to the service – all of which, placed additional pressures on services. However, we have also seen PR services adapt, delivering programmes in new ways to increase access to those who need it and meet the varied preferences of people with lung disease.
We want to continue to see even more people with lung disease access high-quality PR, as it is one of the most effective ways of helping people manage their condition. We know that even before the pandemic, there were significant barriers to accessing PR such as services only being available in certain locations, reduced workforce, and a lack of awareness of PR as a treatment option among patient and healthcare professionals alike.
We’re pleased that NHS England (NHSE) are developing a new five-year vision to refresh the existing Long Term Plan commitments for PR and help convey NHSE’s goals for improving PR. We sought to influence this vision with our recent position paper with evidence and recommendations for where NHSE’s vision could go further than commitments outlined in the Long-Term Plan to improve access to high-quality PR services for people with a range of different respiratory conditions.
Here is a summary of our recommendations:
• Expanding PR to people with MRC breathlessness scores of 2 and above and people with other respiratory conditions.
• Better data collection to understand both gaps in accessing PR and what makes quality PR.
• Better data collection on online/hybrid PR models.
• Identifying and reducing health inequalities.
• A sustainable PR workforce.
• The development of resources that include patient and carer experiences, as a means of improving referrals and uptake of PR.
• Strong patient involvement in NHSE’s 5 Year PR Vision.
– Essie Mac Eyeson