World COPD Day 2022 - Pulmonary rehabilitation: Changing lives for those living with a respiratory disease

Wednesday, November 16, 2022

 In this blog on World COPD Day (16th November 2022), Dr Jonathan Fuld, Consultant Physician, Respiratory Medicine considers why healthcare professionals should utilise the referral option of pulmonary rehabilitation for people who have been diagnosed with a respiratory disease.

Imagine this.

You’ve just been diagnosed with a lung disease, let’s say chronic obstructive pulmonary disease (COPD), characterised by symptoms of increasing breathlessness, a persistent cough or wheezing and frequent chest infections.

Overwhelmed by these physical symptoms, you may be experiencing anxiety, your freedom is dramatically reduced and your ‘life is shrinking’ which is a phrase commonly used by our patient experience partners.

This paints a bleak picture, especially as these symptoms are known to gradually worsen over time and on occasion, usually in winter, flare ups cause a sudden deterioration, of symptoms often requiring emergency hospital admissions.

But what can we do, as healthcare professionals to support this cohort of patients?

Patients will have been treated with inhalers and this will have helped them, but there is so much more that we can offer.

Pulmonary rehabilitation (PR), a course of exercise and education classes for people with COPD, does so much to support patients to manage their symptoms, live well and often is transformative.

PR helps build muscle strength and improve fitness through supervised group classes enabling people to do activity with less demand on their breathing.  Day-to-day tasks become easier and the confidence to live life in a different is so valued by participants.

Patients often comment on the benefits of meeting others who have respiratory conditions so they can share experiences and coping mechanisms. Personalised support plans also support patients to set personal goals and track progress.

That’s why best practice is to refer a patient for PR once breathlessness impacts upon their ability to live well.

PR also has benefits to the healthcare system - it reduces pressure on NHS services as it lowers unplanned admissions. These are all reasons why pulmonary rehabilitation is an NHS Long Term Plan priority.

NHS England is driving uptake of PR through a 5-year plan for PR services. This involves using data and modelling to plan local PR provision that meets current and future demand and funding to develop and adopt ways of working that increase personalised services and, capacity and use of resources.

Access has often been a problem with PR, especially in rural areas, so the NHS is developing innovative and inclusive models of delivery that widen access to PR programmes and improve completion rates. 

We also recognise the importance of providing local teams and respiratory networks with assurance of PR programme quality. So, in 2019 the NHS and Royal College of Physicians launched an accreditation scheme for providers. We are proud that now, three years on since the launch, 100 out of our 190 services have signed up to the scheme, therefore committing to providing the best possible care for respiratory patients. This is with no doubt a milestone that is worth celebrating this #WorldCOPDDay.

If your service hasn’t yet signed up and you would like to find out more about the accreditation, please contact or 020 3075 1407

To find out more about other tools mentioned in this blog such as modelling tools for PR demand and capacity and personalised care plans, please contact: