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Pulmonary rehabilitation provision during the pandemic

Posted By Johan Barr

"Pulmonary rehabilitation provision during the pandemic"

About: Perth Royal Infirmary / Respiratory Medicine

(as the patient),

I have emphysema, severe enough to require home oxygen. I require to have done a pulmonary rehabilitation course in order to qualify for assessment for lung volume reduction treatment.

Understandably these courses can no longer be taken in person. However the service at PRI has continued virtually. Unfortunately the criterion for accessing this requires the patient to attend the physiology department in PRI in person for assessment.
I live alone and my car is out of action. I would  therefore be required to find someone willing to take me at a time when the scottish government advice is that there should be no car sharing with individuals from separate households.

I have explained that as a person in the shielding category I am not prepared to take this risk and was told that I may not take advantage of the course. 

The respiratory nurse service is prepared to make home visits to patients in my situation and it is not clear why the physiology department cannot do the same and is apparently happy to put vulnerable patients at risk.. 

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Responses

Response from Debbie Baldie, Senior Nurse, Practice Development, Nursing and Midwifery Directorate, NHS Tayside 3 years ago
Debbie Baldie
Senior Nurse, Practice Development, Nursing and Midwifery Directorate,
NHS Tayside

I work with senior nurses to improve care standards through providing training and support

Submitted on 27/11/2020 at 16:57
Published on Care Opinion at 16:57

Thank you for your feedback. I am sorry that you have had difficulty accessing our Pulmonary Rehabilitation service. To participate in Pulmonary Rehabilitation, it is recommended that we complete an assessment to be able to safely prescribe the exercise component. At present in Perth & Kinross, we do not have the facility to do this in a home visit. Therefore, patients usually have to attend Perth Royal Infirmary Physiotherapy Department for the one-off assessment. As the majority of patients referred to Pulmonary Rehabilitation would have been in the Shielding category, we have strict infection control & PPE procedures in place to minimise infection risks. I am sorry if we did not explain this in your contact with our service. With regards to your individual circumstance, if you would still be keen to participate in our home-based Pulmonary Rehabilitation programme, then if you contact me, we could discuss if there are alternative options to facilitate this. My telephone number is 01738 473723 and there is an answering service available if we miss your call.

Lindsay Willis,

Clinical Specialist Physiotherapist - Team Leader

Perth Royal Infirmary

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by Johan Barr (the patient)

While I have stated that the response is helpful I would like clarification of the following:

In the response it is stated that "To participate in Pulmonary Rehabilitation, it is recommended that we complete an assessment to be able to safely prescribe the exercise component."

As I stated in my letter a respiratory nurse came to my house to check my need for ambulatory oxygen.The test for this was to see how often, without using my arms, I could go from sit to stand in 1 minute. I managed to do this 19 times. There was no prior assessment for this exercise.

This must be inconsistent with the need for assessment for pulmonary rehabilitation, as I know that the exertion required for this exercise exceeds any that form part of pulmonary rehabilitation. I have been doing the pulmonary rehab exercises in the British Lung Foundation videos and the sit to stand exercises are done in sets of 10. Secondly, surely if I am able to do 19 without any harm other than being breathless, I must qualify as a safe candidate for pulmonary rehabilitation.

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