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Pulmonary rehabilitation in prison

Helen helps to set up a pulmonary rehabilitation class for a unique community.

Nursing Times Awards 2013

As a physiotherapist who supports with patients with lung conditions, I'm no stranger to running exercise classes in the community. But one day at work I was approached by Nina, a nurse with a slightly more unusual offer for me.

She asked me whether I would be interested in helping her to set up a pulmonary rehabilitation course at the prison she worked at.

At first I was very nervous at the idea. Then, after some thought, of course I said yes – this was a really interesting chance to make a difference to people with lung conditions in prison, a hard to reach group.

Preparing for the first class

Accessing pulmonary rehabilitation can sometimes be a problem for people even within a community setting. And no-one has ever tried to reach this unique group of patients. Prisoners are more likely to smoke than the general population and are quite likely to have an undiagnosed lung condition, so there was a real need for this type of support.

Nina and I spent many months talking with lots of different people working within the prison to make sure we had a good idea of what was needed in our class. We screened prisoners for lung conditions and then put all the wheels in motion to get the classes started. After lots of preparation, we launched the first class in February 2013.

Successful, safe support

The prisoners were wary at first. They did not quite believe that they had a space to share their experiences of what it is like to live with COPD and other conditions.

Not only were they able to spend 2 hours with other people within the prison, but they could exercise with supervision and be supported every week to get fitter.

We were also able to offer education sessions which sparked lengthy discussions. We successfully delivered 2 courses of pulmonary rehabilitation safely and effectively.

We were so pleased to prove that it’s possible to deliver this support in a prison. And the feedback from everyone who took part was overwhelming. Often people in prison don’t have much social contact or easy access to specialist health services. They were so grateful for the chance to regularly see health care professionals thanks to the course.

Making an impact

It was fantastic to see just how much some people’s lives improved thanks to pulmonary rehabilitation. Over time, the prisoners involved were soon able to climb the stairs on the wing and stop using nebulisers to control their condition. They were sleeping better and some people were even stopping smoking. Visits to hospital became less frequent and some of the participants began to mentor other prisoners with lung conditions.

The project ended, but that wasn't the end of the journey for Nina and I. We went on to win several awards for our work, including the respiratory nursing category at the 2013 Nursing Times awards. We also produced a guide on how to set up pulmonary rehabilitation in prison.

However, the biggest reward was seeing the impact of our work within the prison. We all have a duty of care to our patients, and prisoners with COPD and other lung conditions will always have the same need as those out in the community.

As Nina says, "Health care equality must be pursued. We have some way to go, but the interest we received shows that the need for prison health care is recognised."

We both agreed that this was a fantastic, life-changing experience for everyone who took part. Nina and I are now determined to continue our work - and we hope to get other people involved too.

If you would like to set up a pulmonary rehabilitation course in a local prison, or you would like to find out more about Helen and Nina's experience, get in touch at

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8 September 2014