HNY Policy and Pathway Repository - Humber

We offer group exercise programmes, health & behaviour change education and risk factor management following a new diagnosis or recent admission with certain respiratory conditions as well as a recent change in respiratory condition health. The acute trust should refer all in scope patients to our service on discharge following a hospital admission, we also receive referrals from the respiratory consultant team within the acute trust following outpatient clinic appointments.

A comprehensive Pulmonary rehabilitation programme consisting of:

• Education and health behaviour change
• Lifestyle risk factor management
• Physical activity and exercise
• Diet
• Smoking Cessation
• Psycho-social health
• Medical risk factor management
• Long-term Management Plan

Acute exacerbation, chest infections- to be dealt with by GP or referral to acute trust.

Community chest clearance- Refer to PARCS team based at HRI, who aim to see the patient within 1 day for physiotherapy.

Chest pain not relieved by GTN spray, open surgical wounds, swollen discoloured or painful calves following surgery, cardiac arrhythmias – 999 should be contacted or attend nearest A&E.

Do Not Refer

• Not registered with a Hull GP
• Under 18
• Housebound patients   
• Not committed to attending the full programme
• Unstable angina/severe cardiac disease
• Recent MI (within the last six weeks)
• Severe aortic stenosis
• Significant aortic aneurysm
• Cognitive impairment that restricts ability to follow instructions safely
• Loco motor disability that would inhibit any form of exercise
• Recent embolism/thrombus/DVT (within the last eight weeks)
• 2nd or 3rd degree heart block
• Patients who require urgent chest clearance

RELATIVE CONTRAINDICATIONS - MAY BENEFIT FROM EDUCATION SESSION WITHOUT THE EXERCISE ELEMENT OR MODIFIED EXERCISE PROGRAMME

• If O2 saturation is <90% supplementary O2 will be required
• If carbon dioxide is above 8kPa liaison with the service will be required
• Left sided Heart Failure will require a modified programme
• Disabling Stroke or Arthritis
• Aneurysm (this is a caution - please indicate size)
• Intermittent claudication
• Metastatic cancer
• Exertional angina
• Unstable asthma
• Resting pulse rate >120bpm
• Resting systolic BP greater than 200mmHg and diastolic greater than 110mmHg

If a patient has significant mobility problems, they should be referred to ‘The Community rehabilitation service’ which is a physiotherapy service that provides intensive home treatment, following this if the patient is then able to mobilise independently they can be referred to the ‘Pulmonary rehabilitation service’ for group exercise sessions.

In-scope patients for HULL Pulmonary rehabilitation service are as follows:

• Registered with a Hull GP
• Patient is 18 years or older
• Diagnosis of COPD (chronic bronchitis, emphysema)
• Interstitial lung disease/ Pulmonary fibrosis
• Lung transplant
• Chronic Asthma
• Bronchiectasis
• Dysfunctional breathing (this will be assessed on an individual basis)

Referrals

NHS E-Referral, email referral form to: chcp.247111@nhs.net . Referrals can be sent 24/7 to CHCP CIC.

Although the Pulmonary rehabilitation service is open Monday - Friday, 8:00am - 4:00pm (excluding bank holidays)

Service Leaflet

CHCP Website