1. Local Pulmonary Rehabilitation in Glasgow and Clyde
Elaine Mackay

2. Population
1.2 million people
COPD
Referrals to Pulmonary Rehabilitation
6 week progamme
Rolling programme
Assessment / reassessment AM
Classes pm

3. Referral Maintenance classes
Pulmonary
Rehabilitation
BREATHING CONTROL
EXERCISE
EDUCATION

5. Referral Sources in 2009 Secondary Care Doctor 633 39.70% Nurse 243
Nurse
243
15.20%
Physiotherapist 97 6%
60.90%
Primary Care GP
275
17.30% PN
329
20.60%
Other 15 1%
38.90%
Total
1592

6. How to improve uptake / adherence?
Information Leaflet
Knowledge of referrers describing service
“Overcoming The Fear Of Exercise”Bulley et al.
Graves et al 2010
Pre-rehabilitation / group opt in

7. Patients experience prior to rehabilitation
Doctor
Inhalers
+/ - spirometry
Ill
Antibiotics
Steroids
Hospital admission
Zero expectation

8. Patients experience prior to rehabilitation
Pulmonary Rehabilitation
Education
Exercise
Self Management
Doctor
Inhalers
+/- spirometry
Ill
Antibiotics
Steroids
Hospital admission
Zero expectation
Prescription only
Empower the patient to self manage
Ethos:

9. Assessment
6 weeks classes
Re-assessment 20

10. Class Locations - Glasgow Southern General Victoria Infirmary
Castlemilk Sports Centre
Tollcross Leisure Centre
Easterhouse Sports Centre
Balgrayhill Comm Centre
Kirkintilloch Leisure Centre
Maryhill swimming Pool
Gartnavel General
Drumchapel Swim Pool
Playdrome Clydebank
Pollok Civic Realm
Class Locations – Clyde
Elderslie Pool
Lagoon Leisure Centre
Vale of Leven Pool
Boglestone Gym
Westburn Church
Symbols
Hospital Site
Maintenance Classes
Maintenance Classes
potentially outwith a 5 mile radius 15
Vale of Leven Hospital
Inverclyde Royal Hospital 7 17 16 10 11
Stobhill Hospital
9. Gartnavel General Hospital 8 6 5
Glasgow Royal Infirmary 4 13
1. Southern General Hospital
Royal Alexandra Hospital
2. Victoria Infirmary 2 14 3

11. map Class venues Travelling distance Taxi if eligible
Encourage benefits application
Am assessment easterhouse hc new
Pm classes

12. Health Education Breathing Control What is COPD? Relaxation
Inhaler technique
Common medicines in COPD
Recognising Warning Signs
Healthy promotion and
Smoking Cessation
Breathing Control
Relaxation
Chest Clearance
Benefits of Exercise
and Maintenance
Anxiety Management
Energy Conservation

13. Standardised service Education across 17 classes
-group session mins
-posters 4-5 with bullet points
Booklet
Exercise / practical

14. Breathing Control Distress -pacing
“Breathing is the basic rhythm of life” Hippocrates

15. Puffing Panicking Cannot get a breath Gasp Panting Heavy chest
Rapid Breathing
Breathed your last

17. Pulmonary Rehabilitation
“More in control of my breathing”
“Know more about my breathing”
“I’ve got some confidence back”
“Love the classes especially the talks”
“Being able to see and talk to other patients”

18. Pulmonary Rehabilitation Staffing Band WTE
Physiotherapy
Team Leader
Band 7
0.4
Physiotherapist
Band 6 1
0.8
Physiotherapist-Clyde
0.2
0.6
Physiotherapist-Rotation
0.5
Total Physiotherapy
3.7
Nursing
Nurse
Nurse-Rotation
Nurse-Clyde
Total Nursing 3
Management
Administrator
Band 4
Clinical Psychologist
Band 8b
Coaches 12

19. Role of team members Physiotherapist Instructor Nurse
Contact with patients
6 weeks of rehabilitation………………………..Maintenance

20. Physiotherapist Instructor
Nurse
Contact with patients
6 weeks of rehabilitation………………………..Maintenance

21. Warm up –cool down 6 weeks of rehabilitation………………………..Maintenance
Physiotherapist Instructor
Warm up –cool down
Nurse
Contact with patients
6 weeks of rehabilitation………………………..Maintenance

22. Vitalty
Council run
Qualified staff
Trained by rehab staff
4 levels of intensity
Cost £2.20

23. Our local services