National Asthma and COPD Audit Programme (NACAP): Pulmonary rehabilitation clinical and organisational audit 2019 report

The report presents information on:

• over 12,000 patients who were assessed for pulmonary rehabilitation between 1 June – 30 November 2019, and
• the structure and organisational of PR services between July and September 2019.

Data includes national and country level performance:

• for key clinical process measures such as waiting times for PR, initially assessments and walking tests, discharge assessments and completion rates for PR. In addition, data on outcomes measures for improvements in exercise capacity and health status are also presented, and
• on organisational factors such as service provision (education sessions, written exercise plans etc) and staff levels.

Key recommendations 

For PR services:

We have defined six key quality improvement (QI) priorities. They were chosen on a strong evidence base for their effectiveness in improving PR care, outcomes and service provision.

• National QI priority C1: Start PR within 90 days of receipt of referral for 85% of patients referred for PR with stable COPD.
• National QI priority C2: Perform all walk tests to accepted technical standards, including ensuring all patients undertake a practice walk test at their initial PR assessment.
• National QI priority C3: Complete PR programmes and discharge assessments for 70% of patients enrolled for PR.
• National QI priority O1: Offer PR to all patients with a COPD self-reported exercise limitation (Medical Research Council (MRC) grade 3–5).
• National QI priority O2: Assess outcomes of treatment for all patients attending PR as a minimum, measures of exercise capacity and health status. Ensure that measures are assessed in line with recommended guidance at the initial and discharge assessment.
• National QI priority O3: Ensure all PR services have an agreed standard operating procedure (SOP).

For people living with COPD and their families and carers:

1. Ask for information on PR when you visit your GP / practice nurse and discuss whether a referral to your local PR service may be beneficial to you.
2. Make sure arrangements are made to refer you to your local PR service, if you are admitted to hospital with a worsening of your COPD.
3. Consider being a patient representative as part of the PR service team, if you have experience of COPD and PR.

For a full list of the recommendations see our downloadable national audit report.

An accompanying patient friendly report will also be published in due course. The patient report will present key findings and recommendations for patients and their families and carers.

How to use this report

This report comes in three parts:

• Pulmonary rehabilitation (PR) clinical and organisational audit 2019: Audit report – this presents key findings and recommendations for providers across the service including: PR services, commissioners, sustainability transformation partnerships (STPs), health boards, primary and secondary care providers and patients and carers.
• Pulmonary rehabilitation (PR) clinical audit 2019: Data analysis and methodology report – this contains the full data analyses from which the key clinical findings and recommendations have been derived. The data are presented largely in tabular form, with explanatory notes throughout.
• Pulmonary rehabilitation (PR) organisational audit 2019: Data analysis and methodology report – this contains the full data analyses from which the key organisational findings and recommendations have been derived. The data are presented largely in tabular form, with explanatory notes throughout.

Please note that all appendices for this report, including participation information and the full methodology, can be found in the clinical and organisational data reports.

Downloads

The following outputs are available for the pulmonary rehabilitaiton clinical and organisational audit 2019 report.

Pulmonary rehabilitation (PR) clinical and organisational audit 2019 report

The national clinical and organisational audit report contains key findings and recommendations and includes PR service case studies which showcase good practice.

Pulmonary rehabilitation (PR) clinical audit 2019 data and methodology

This report contains the full data analysis for each data item from the PR clinical audit and unadjusted benchmarked key indicators for participating services in England, Scotland and Wales. The data are presented largely in tabular form, with explanatory notes throughout.

Pulmonary rehabilitation (PR) organisational audit 2019 data and methodology report

This report contains the full data analysis for each data item from the PR organisational audit. The data are presented largely in tabular form, with explanatory notes throughout.

Pulmonary rehabilitation (PR) clinical audit 2019_Benchmarked key indicators

This report shows unadjusted benchmarking of key indicators for participating services in England, Scotland and Wales.

Pulmonary rehabilitation (PR) clinical and organisational audit 2019_Quality improvement (QI) priority concise guide

This concise guide provides a summary of the PR clinical and organisational audit 2019 quality improvement priorities with their accompanying rationale and tips for achieving the priority.

Pulmonary rehabilitation (PR) clinical and organisational audit 2019_Quality improvement (QI) slideset

This slide set pulls together the key findings of the report with a QI focus.

Pulmonary rehabilitation (PR) audit 2019: Patient outputs

The PR Combined Audit 2019 Patient Report presents key findings and recommendations from the audit for patients, carers and their families, to help them understand the care they should be receiving and to access the best possible care. A screen-reader compatible version of the report is also available for those who see differently.

Your pulmonary rehabilitation journey – Guide to PR is a pocket guide for people who are referred to PR, to let them know what to expect from their programme, and what to do to ensure they receive the recommended care. It is designed for use from the point of referral onwards, and services are welcome to download and distribute it to patients.

Data and variables

This presents aggregated, service-level attainment data as used in the analysis for the pulmonary rehabilitation (PR) clinical and organisational 2019 audit report. The data description file provides an explanation of the variables found in the data file.