Increasing access to pulmonary rehabilitation in Barnsley

Date: 14 February 2017

South West Yorkshire Partnership NHS Foundation Trust and Barnsley CCG are making it easier for patients to access pulmonary rehabilitation across the borough.

In addition to sessions at Dorothy Hyman Stadium, from March 2017 the programme will also be delivered from Hoyland Sport Centre and the Recovery Centre (Gawber Road, near Barnsley Hospital). The length of the standard programme has also been reduced from 8 to six weeks.

To help patients get to sessions public transport travel guides have been developed. Dial a Ride can pick patients up from their homes and deliver to the venue for just a small fee. Patients on a low income may be able to claim back transport costs. The patient transport service is now available for patients who meet the eligibility criteria.

There are many benefits for taking part in pulmonary rehabilitation. It improves quality of life and mortality from chronic obstructive pulmonary disorder (COPD) and other chronic respiratory diseases. As patients are fitter it also decreases demand on primary care, decreases hospital admissions and re-admissions. After flu vaccination and stopping smoking, pulmonary rehabilitation is the most cost effective intervention for COPD.

Pulmonary rehabilitation should be a core component of the overall management of all patients diagnosed with COPD and other chronic respiratory conditions who have disabling breathlessness. Over 8,000 people in Barnsley have COPD, of whom 2,768 have a MRC dyspnea score of ≥ 3.

In 2015/16 there were 1,141 emergency admissions for COPD – this is 70% higher than expected when compared to other CCGs with former mining communities and similar levels of deprivation and smoking. Admission rates from COPD have increased by 20% over the last 4 years.

Jill Young, Team Leader, Cardiac/Pulmonary Rehabilitation, said: “Despite the very strong evidence base for pulmonary rehabilitation the number of people having pulmonary rehabilitation in Barnsley is low.

“If we can achieve a threefold increase in the number of people having pulmonary rehabilitation to 400 patients a year, we could make a real impact on the quality of life for people with COPD and other disabling chronic respiratory diseases in Barnsley.

“This would help decrease hospital admission and readmission rates.”

Carol was diagnosed with COPD in primary care. Her daughter lived overseas and had seen on the internet a video about pulmonary rehab. She asked Carol to watch it and see if it was available in Barnsley.

Carol said: “I was really impressed especially when the person on the video explained what an amazing difference you will see in a very short time.”

Carol made an appointment with her GP and asked if a referral to pulmonary rehab would be suitable for her. After being accepted she attended the programme and managed to walk an extra 100 metres on her post programme walk test.

When asked how the programme has benefited her, Carol said: “I can do more physically, and use my inhalers correctly. I loved the education sessions. I joined the long term exercise sessions at Dorothy Hyman 18 months ago, go twice a week and have made so many new friends.”

In line with NICE and British Thoracic Society Guidelines, clinicians can refer all patients:

  • Functionally disabled by COPD (usually ≥ MRC grade 3) or other chronic respiratory diseases (eg pulmonary fibrosis)
  • Who have had a recent hospitalisation for acute COPD exacerbation  (start within 1 month, repeat if > 12 month since last had pulmonary rehabilitation)

Patients who initially decline post exacerbation pulmonary rehabilitation within one month of admission should be offered elective pulmonary rehabilitation.

Repeat pulmonary rehabilitation should be considered in patients who have completed a course of pulmonary rehabilitation more than a year previously. Earlier repeat pulmonary rehabilitation should be considered in patients with accelerated physiological decline or if additional benefits on a shorter timescale would be clinically valuable.

Patients have an individual appointment prior to commencing the programme and on completion. This includes baseline measures so that patients can see the improvements in their health after the course.

Referral forms are available on the BEST website and on your clinical systems. Transport guides are also available on the BEST website.

For more information please contact – Cardiac/Pulmonary Rehabilitation, Dorothy Hyman Sports Centre, Cudworth S72 8LH  or call 01226 719781.