Increasing access to pulmonary rehabilitation for people with lung conditions could save NHS England £69m every year

If eligible COPD sufferers had access to pulmonary rehabilitation, NHS England could see a reduction of 150,924 GP appointments, and 26,633 fewer hospital admissions per year, according to data released by the Taskforce for Lung Health.

Improving access to pulmonary rehabilitation (PR), an exercise and educational treatment programme tailored for people with lung conditions, could save NHS England up to £69,037,429 every year, according to the Taskforce for Lung Health. [1]

The findings have been released this week to mark ‘Pulmonary Rehabilitation Week’ (15-21 June), which aims to raise awareness of the life-changing treatment for people with lung conditions. Studies show that the treatment, which incorporates exercise lessons and guidance on managing symptoms and living with a lung condition, is more effective than some drug-based treatments in its track record for improving the wellbeing of patients.[2]

Crucially, pulmonary rehabilitation can prevent the need for additional GP appointments and hospital admissions by reducing exacerbations for people with chronic obstructive pulmonary disease (COPD), the second biggest lung condition after asthma.

According to the Chartered Society of Physiotherapy (CSP),[3] a member of the Taskforce for Lung Health, 85% of exacerbations for people with COPD are dealt with through primary care. Analysis of CSP data by the Taskforce found that a total of 177,558 exacerbations could be avoided if those potentially eligible were referred to pulmonary rehab. Notably, as many as 150,924 GP appointments are made annually to support patients who may have benefited from PR treatment, instead.

The cost of a single exacerbation for someone with COPD in primary care is estimated to be approximately £175. This, alongside the fact that there are 23,633 COPD related emergency admissions every year, each costing an average of £1,593, means that NHS England could be saving millions of pounds if pulmonary rehab was accessible to everyone with COPD who may be eligible for the treatment.

Pulmonary rehabilitation can help people with lung conditions stay active, due to the exercise element of the treatment. To support this move to raise awareness of pulmonary rehabilitation, the British Lung Foundation, another member of the Taskforce, released data today which found that 3 in 5 people (59.2%) shielding in England with lung conditions have said that they are less fit since lockdown.[4] In contrast to this, around half (50.2%) of people in England who would normally go to PR treatment said that the exercises from pulmonary rehab classes had helped them to stay fit during lockdown.[5]

Some people recovering from covid-19 are likely to require treatment similar to pulmonary rehabilitation in order to make a full recovery in the long term. Historically, pulmonary rehabilitation services have not been available in some parts of England or have had limited eligibility criteria, and transport or health issues have made treatment harder to access.

With the outbreak of covid-19, face-to-face pulmonary rehabilitation sessions have stopped. When pulmonary rehabilitation classes resume, it is likely that there will be a backlog of referrals and lengthy waiting lists, but the Taskforce argues that people living with lung disease need support now in order to live well with a lung condition. The Taskforce for Lung Health is now calling for a widespread digital offering to be in place to assist those who need support before face-to-face treatment can resume.

Jessica Eagelton, policy officer at the British Lung Foundation, a member of the Taskforce, said, “Pulmonary rehabilitation helps people cope with feeling out of breath, improves muscle strength so that people can breathe more efficiently, and generally improves fitness. People describe feeling less tired, feeling less breathless and enjoying their day to day lives more.

“For a long time, there have been issues with access to pulmonary rehabilitation, but the need to offer this form of support to people with lung conditions has never been more pressing than it is now.

“That’s why the Taskforce for Lung Health is calling for a rollout of digital pulmonary rehabilitation services to people shielding or considered vulnerable to covid-19. The reality is that if people cannot access pulmonary rehab treatment at all, they may be less resilient to potential later ‘waves’ of covid-19 and winter respiratory infections. In the meantime, people can find online resources to help them exercise at home, for example on the British Lung Foundation website.”

Although the Taskforce analysis of the cost to the NHS only covers COPD, the second biggest lung condition in the UK, pulmonary rehab is also known to help people with other lung conditions.

Rita Frazer, 91, a retired civil servant from Bournemouth, is one of the people who has been benefiting from exercises she has learnt in pulmonary rehabilitation. Rita has idiopathic pulmonary fibrosis, a lung condition which makes it difficult to breathe. Before lockdown, Rita went to pulmonary rehabilitation sessions and the gym multiple times a week, as she found it helps her condition. Now, Rita is trying to access support online, as well as continuing to exercise in the care home where she lives with her husband, Eric, 100, who has dementia.

Rita commented, “Exercise has been the best form of treatment for my condition and has made it so much easier for me to breathe and live well. Lockdown has been really hard because I can no longer go to the gym, but it has been really helpful to be able to use what I have learnt from pulmonary rehabilitation sessions to make sure I keep fit while I need to shield to protect myself.

“I have found the British Lung Foundation online resources incredibly helpful, but I do hope there is an option to access pulmonary rehabilitation online, too, so that people like me can get help during this difficult time”

Recently, The British Lung Foundation has also launched a technology guide for people with lung conditions looking for support.

Alison Cook, chair of the Taskforce for Lung Health, said, “A lot of people with lung conditions have told us that that they have seen their mental health and fitness levels deteriorate since lockdown.

“It is imperative that people with lung conditions can continue to access treatment, and that every effort is made to ensure that services resume, despite the challenges of covid-19.

“Increasing access to pulmonary rehabilitation could save millions of pounds each year, and improve the wellbeing of thousands of patients across the country. The digital innovation we have seen within the NHS since covid-19 is an opportunity to take innovative steps to now increase access to this life changing treatment for people with lung disease”.  

To find out more about the Taskforce for Lung Health plan for lung health in England, visit: https://www.blf.org.uk/taskforce/plan

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Notes to editors:

For more information or for interview requests, please contact Eve Kasperaviciute on 07710 707871 or email [email protected]

1. Chartered Society of Physiotherapy, COPD PRIME tool, 2017. https://www.csp.org.uk/documents/copd-prime-tool. You can find more information on the PRIME tool, here: https://www.csp.org.uk/professional-clinical/professional-guidance/pulmonary-rehabilitation-copd

2.  The British Lung Foundation ran an online survey from 6 May-14 May on how people with lung conditions are coping with coronavirus and the lockdown. The survey gained 14,312 responses. 27.3% of respondents had pulmonary rehabilitation in their care for their lung condition.

3. COPD Value Pyramid, https://www.networks.nhs.uk/nhs-networks/london-lungs/latest-edition-of-thorax-publication.

4. Taskforce analysis based on the Chartered Society of Physiotherapy COPD PRIME Tool to work out the cost of 150, 924 fewer exacerbations and 26,633 hospital admissions. Savings are at 13%.

The British Lung Foundation:

The British Lung Foundation is fighting to help the 1 in 5 people in the UK affected by lung disease. The charity provides support and information to improve the everyday lives of people with lung disease. We are also campaigning for better diagnosis, treatment and prevention for now and the future. For further information, please visit www.blf.org.uk.

The Taskforce for Lung Health

The Taskforce for Lung Health is a unique collaboration between patient representatives, health care professionals and other experts. Over 30 members have a shared vision for lung health; we want to transform the care and treatment for patients and change the mortality rate for lung disease, which has barely improved in over a decade.

Coming together for the first time in 2018, we developed a five-year plan to improve lung health in England. Our report makes vital, realistic recommendations to NHS England and other governing bodies about all aspects of lung health; from prevention and diagnosis right through to end of life care. Together we’re giving people with lung disease a powerful voice. For further information visit www.blf.org.uk/taskforce

[1] Taskforce analysis based on the Chartered Society of Physiotherapy COPD PRIME Tool to work out the cost of 150, 924 fewer exacerbations and 26,633 hospital admissions. Savings are at 13%.

[2] https://www.networks.nhs.uk/nhs-networks/london-lungs/latest-edition-of-thorax-publication

[3] Chartered Society of Physiotherapy, COPD PRIME tool, 2017. https://www.csp.org.uk/documents/copd-prime-tool

[4] The British Lung Foundation ran an online survey from 6 May-14 May on how people with lung conditions are coping with coronavirus and the lockdown. The survey gained 14, 312 responses. 27.3% of respondents had pulmonary rehabilitation in their care for their lung condition.

[5] The British Lung Foundation ran an online survey from 6 May-14 May on how people with lung conditions are coping with coronavirus and the lockdown. The survey gained 14, 312 responses. 27.3% of respondents had pulmonary rehabilitation in their care for their lung condition.