Pulmonary Rehabilitation: The Breathe Better, Do More Group

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Islington
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Under Review — this page was due to be reviewed by Tuesday, 10 May 2022. The information shown here may be outdated.

Covid-19 service update

During the outbreak Covid-19, the pulmonary rehabilitation service is not providing a face-to-face service. Patients will instead be offered a remote assessment by video or telephone. Referred patients will be risk stratified and a remote service provided to those who are deemed safe to exercise without a face-to-face health professional present. Exercise tests will be modified and carried out with safety in mind.

The service will use measurement of recent physiological parameters sent via referral or available on the patient shared care records, e.g. blood pressure, heart-rate, and peripheral oxygen, to help determine a person’s safety to exercise from a cardiovascular and respiratory perspective. The referral will be declined if these are unavailable.

If patients are unable to access this service on the internet, an exercise plan and self-management booklet will be provided via the usual postal service.

Please note: All patients must consent to a referral to the pulmonary rehab service. The service continues to receive referrals for patients who have not provided consent.

The Pulmonary Rehab referral criteria have been modified for patient safety while the remote service offer is in place:
 and patients must meet all criteria before referral:

  • agrees to referral after full explanation
  • chronic respiratory disease (E.g. COPD, bronchiectasis and Pulmonary fibrosis) with breathlessness that limits functional ability (usually MRC 3 or more)
  • optimal medical management
  • able to walk 5m independently (with or without walking aids)
  • willingness to undertake web-based PR.
  • if non-English speaking, a regular carer/family member can attend to help interpret 

Modified exclusion criteria are:

  • severe/uncontrolled heart failure
  • uncontrolled cardiac arrhythmias or hypertension
  • myocardial Infarct in last six weeks
  • unstable angina
  • any other unstable cardiac disease
  • untreated/uncontrolled diabetes or epilepsy
  • infection control risk e.g. untreated pulmonary TB
  • significant co-morbidities e.g. stroke, dementia, severe arthritis that render them unsafe/unable to exercise 
     

 


The Breathe Better, Do More Group is a programme of activity and education for people living with long-term lung conditions. The programme should be offered to all appropriate people with chronic obstructive pulmonary disease (COPD), including those who have had a recent hospitalisation for an acute exacerbation and those who consider themselves functionally disabled by COPD (usually MRC grade three or above). Patients are eligible to complete the pulmonary rehabilitation every 12-18 months.

The programme is run by expert respiratory physiotherapists who tailor sessions specifically to individual patients, while also supporting in a group format. The programme consists of eight weeks of  twice-weekly two-hour sessions at two local venues.

In each session patients will spend an hour learning about COPD from a number of specialists, including how to manage the condition and control symptoms better. At the end of the programme they should be able to: walk approximately 50 metres further, feel less breathless, and feel more confident in managing their COPD.

Pulmonary rehabilitation is highly cost-effective in the management of COPD. Pulmonary rehabilitation also reduces admissions to hospital and is one of three interventions that prolong life in COPD; the other two are long-term oxygen therapy in hypoxic patients and smoking cessation.


Eligibility criteria

Inclusions

  • Respiratory diagnosis with breathlessness that limits functional ability (usually MRC 3 or more)
  • Optimal medical management
  • Able to walk five metres independently (with or without walking aids)
  • Able to follow simple commands (in a group environment)
  • Agrees to referral after full explanation
  • Can commit to attending twice a week for eight weeks (if not, once a week will be offered with a commitment to working independently at home)
  • The patient is able to make their own way to the venue

Exclusions

  • Severe/uncontrolled heart failure
  • Uncontrolled cardiac arrhythmias or hypertension
  • Myocardial Infarct in last six weeks
  • Unstable angina
  • Any other unstable cardiac disease
  • Untreated/uncontrolled diabetes or epilepsy
  • Infection control risk e.g. untreated pulmonary TB
  • Significant co-morbidities that make it not safe/not possible to exercise in a group setting e.g. stroke, dementia, severe arthritis

How to refer

The following clinicians can refer to this service: GPs

EMIS form

Referral methods: Email

Completed EMIS referral forms should be emailed. 

e: articentralbookings@nhs.net  

t: 020 3316 1111


Locations

Holloway Community Health Centre

Tuesdays and Fridays 12pm-2pm

Whittington Hospital (Physiotherapy Department)

Tuesday and Fridays 1:30pm-3:30pm


External Links