LIVERPOOL
PULMONARY REHABILITATION
SERVICE
ANNUAL REPORT
SUMMARY
(01/04/15 – 31/03/16)
REPORT SUMMARY AND CONCLUSION
Over the last 12 months, 922 referrals been triaged by the PR team. The monthly referral rate has remained variable over the course of the year (46 – 103 referrals/month) with a monthly average referral rate of 77 referrals per month. The main source of referrals remains with nurses (43.0%) with 89.0% referrals originating from nurses in primary care. The predominant patient group remains consistent with patients with a primary diagnosis of COPD making up 88.6% of the patient cohort for this fiscal year.
The health outcomes on physical health, mental health, and patient knowledge all show significant improvements across all variables assessed:
- 29.4% improvement in walking distance
- 20.0% improvement in upper limb and lower limb strength
- 20% improvement in respiratory disability using the MRC dyspnoea scale
- 18.2% improvement in functional respiratory disability using the dyspnoea during activities of daily living
- 22.2% improvement in anxiety
- 25.0% improvement in depression
- 22.6% improvement in self-management knowledge
PR patient activity data indicates that 6888 (5413 community based and 1475 hospital based) scheduled patient attendances were recorded for this fiscal year with 3577 face to face contacts being recorded (2849 community based and 728 hospital based).
Patient response to intervention in terms of the LTC-6, demonstrates a strong shift towards improved confidence in self-management, engagement with clinical support and clinical intervention post intervention.
Post intervention review of PR goal achievement is carried out with each patient that completes the programme. Subjective and objective evidence of goal achievement was observed in 91.3% of the patient cohort.
Post intervention activity management is offered to all patients who are cardiovascularly stable to exercise with 72.0% opting for the Home exercise Programme using the NaJo exercise diary.
Patient satisfaction remains consistently high with the results of the patient satisfaction snap shot audit finding that 100% of patients surveyed reporting:
- the venues were suitable
- they received adequate support/guidance during the programme
- they found the education sessions useful or helpful to manage their condition better
- the exercises were set at a suitable level for them as an individual
- they felt more confident that they understood their condition better and were now able to manage it better
- they will be continuing with exercise once they completed the programme
Pulmonary rehabilitation as provided by the Liverpool Heart and Chest Hospital (LHCH) in partnership with Liverpool CCG is accessible to all patients with a chronic respiratory disease in Liverpool. The team continues to consistently provide an excellent standard of care for patients who access the service and this includes after care. Patients are able to access a flexible programme of care that is specifically geared to meet their health and psychosocial needs, in a format that facilitates the development of self-management skills and positive life style changes to minimise the impact of their lung condition on their health related quality of life.