Cambridgeshire Pulmonary Rehabilitation
Pulmonary rehabilitation includes patient education, exercise training, psychosocial support and
advice on lifestyle changes. Pulmonary rehabilitation has been shown to improve exercise capacity,
reduce breathlessness, improve health-related quality of life, and decrease healthcare utilisation. The
majority of patients considered for pulmonary rehabilitation programmes will have chronic obstructive
pulmonary disease (COPD). Pulmonary rehabilitation should be offered to all patients who consider
themselves functionally disabled by COPD.
In Cambridgeshire there has been a historic under provision of Pulmonary Rehabilitation, a situation
that has been addressed through a procurement process.
We are pleased to announce that Central Essex Provider Services will be offering a locally
based Pulmonary Rehabilitation Service for your patients with COPD at Ross Street
Community Centre, 75 Ross Street, Cambridge CB1 3UZ on Tuesday and Friday afternoons.
The 8 week courses run with a maximum of 16 patients on a rolling basis. It is important to
ensure value for money that these courses run full from day one. Please help us to achieve this
by referring your patients with COPD who do not have any of the exclusion criteria on the
referral form. If you have any questions please call the Pulmonary Rehabilitation service
(contact details on the referral form).
The existing services provided by Cambridgeshire Community Services will continue at Brookfield
Hospital and at the Oaktree Centre.
ACTIONS
1. Identify all patients with a diagnosis of COPD or COPD like diagnosis.
2. Offer to all appropriate people with COPD, including those who have had a recent
hospitalisation for an exacerbation and those who consider themselves functionally
disabled by COPD (usually MRC grade 3 and above).
3. Pulmonary rehabilitation is not suitable for people who cannot walk, have unstable
angina or who have had a recent myocardial infarction.
4. Arrange for the patients to be called in and offered treatment by a member of the
Practice team who understands the benefits of Pulmonary Rehabilitation.
5. Outline the commitment required for pulmonary rehabilitation and the consequent
benefits to people with chronic obstructive pulmonary disease (COPD).
6. CECS will tailor the programme to individual needs, and include physical training,
disease education, and nutritional, psychological and behavioural intervention.
7. Refer all patients who express an interest.
What Are the Benefits of Pulmonary Rehabilitation (PR)
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The rehabilitation process incorporates a programme of physical training, disease education,
nutritional assessment and advice, and psychological, social, and behavioural intervention.
Respiratory rehabilitation is effective in helping to relieve dyspnoea and improve control of
COPD.
PR for patients with COPD has also been shown to relieve fatigue, improve emotional function
and enhance patients' sense of control over their condition
Patients who have undertaken PR are less likely to be admitted to hospital for all causes than
non–rehabilitated contemporary.
Setting
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Research by the Cambridgeshire Community Services demonstrated that even within
Cambridge City itself patients are un-willing to travel for PR. Our specification addressed this
by specifying that PR should be offered locally to patients across the entire county. CECS
sessions will be held in local venues that are fully assessed as safe and suitable for PR.
Once the service is running across the county patients will be able to choose which centre
they wish to attend.
Programme content
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Programme offers patients a two hour session twice a week for 8 weeks and includes physical
exercise, disease education, and psychological and social intervention.
Each session includes 60 minutes of exercise. The patients are then offered refreshments
followed by the education component that lasts for an hour. Physical aerobic training,
particularly of the lower extremities (e.g. brisk walking), is core to the programme. Exercises do
not involve technical equipment so that patients can continue with the same exercises at
home.
Patients are offered two supervised sessions a week and are encouraged to exercise once a
week at home without supervision.
Upper limb and strength-building exercise is also included.
Exercise prescription should be individually assessed.
Individual training intensity is recorded and increased through the programme if appropriate
and tolerated.
Training frequency should involve three sessions (20-30 minutes) per week, of which at least
two will be supervised.
Supplementary oxygen during training should be provided if necessary. Please consult the
Specialist Nursing – Respiratory team.
If your patient is on oxygen it is essential that you provide their latest blood gases results
when you refer them so that their oxygen can be administered safely during their sessions.
Comprehensive disease education for patient and family is an important part of overall
management and can be included within the rehabilitation programme.
Individual advice on physiotherapy, nutrition, occupational therapy, smoking cessation, end of
life planning, and physical relationships are also be included.
Referral Process
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Referrals can be made by any Health Care Professional.
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The patient should be involved in the decision to undertake Pulmonary Rehabilitation.
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The referral form attached should be sent to the fax number at the top of the form.
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The patient will then be called for an assessment after which they will be added to next
available course, subject to the patients’ suitability and agreement.