NICE standards could help bids to fund COPD rehab

CSP professional adviser Carley King: 'We hear of pulmonary rehab only being commissioned on a temporary basis'

The National Institute for Health and Care Excellence (NICE) COPD quality standards, published on 4 February, says programmes of pulmonary rehabilitation should start four weeks after people are discharged from hospital.

They say the programmes must deliver a minimum of twice-weekly supervised exercise sessions over six weeks, ‘individually tailored’ to optimise each person’s physical performance and autonomy.

CSP professional adviser Carley King said: ‘We hear of many pulmonary rehab services only being commissioned on a temporary basis.

‘But this quality standard embeds pulmonary rehab services as a core component of care for people with COPD.

‘Physios can use it to help make the case for permanent funding of pulmonary rehab services that meet the NICE requirements.’

The document says that people with stable chronic COPD, who find it difficult to exercise because of breathlessness, should also be referred for pulmonary rehabilitation.

Standardising practice

It should be standard practice that people with an acute exacerbation of COPD and persistent acidotic hypercapnic ventilatory failure have non-invasive ventilation, if there is no improvement after an hour of optimal medical therapy.

Laura Breach of the Association of Chartered Physiotherapists in Respiratory Care told Frontline that her organisation always welcomed national quality standards.

‘Guidelines are often seen as just that – guidance, rather than frameworks for quality care. But standards send a stronger message and can help healthcare professionals to gain commissioning for services, particularly in areas where there is a lack of provision.’

She said that where provision of services for COPD patients is limited, quality standards will result in improvements in patient care.

But she added: ‘While the content of the standards is relevant, there are some notable omissions such as rescue packs, domiciliary non-invasion ventilation and palliative care, and the implications for established physiotherapy services are limited as a result.’