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Posted on 5 Aug 2020

The arrival of the Covid-19 pandemic has forced a lot of NHS services to look at different ways of working to continue to deliver safe, high quality care to patients.

This has been especially true for Nottinghamshire Healthcare’s Community Respiratory Physiotherapy team, which faced the challenge of continuing to provide services to patients needing pulmonary rehabilitation, a particularly vulnerable and high-risk group.

The team got to work quickly, developing a virtual pulmonary rehab offer for patients living in Gedling, Hucknall and Rushcliffe using national guidance and benchmarking.

The goal was to enhance and optimise care, with three pathways being created;

• Virtual online consultations with the use of app and web-based programmes with weekly telephone support
• Telephone consultations with the use of app and web-based programme with weekly telephone support
• Homebased with Telephone consultations with the use of paper exercise programmes and patient information leaflets, with weekly telephone support

The determination of the team to create an innovative approach during this time has seen them continue to deliver high quality rehabilitation using www.SpaceforCOPD.co.uk and the MyCOPD phone app as virtual platforms. This enthusiasm, along with their hard work and commitment, has resulted in great engagement in the six-week programme.

To ensure safety, every patient recruited to each pathway gets a home visit for an assessment of their blood pressure, oxygen saturations, heart rate and breathlessness levels. They also undertake a timed ‘sit to stand’ test, while questionnaires are completed as a pre-assessment before their consent is gained. If patients have been shielding, this assessment is completed by a virtual online consultation.

The patient journey and experience has been at the forefront of their approach, and the team has ensured they get regular feedback from users and staff. This has been imperative, as it has helped them evolve and enhance the current offer.

Annabelle, 58, from Calverton says: "I found it really helpful, particularly in the current situation.  It has given me something to aim for, especially with having to write it down.  It has been really good being able to help myself and has given me structure around the GP’s advice to ‘do something’.

The team have stayed connected by using Microsoft Teams as their virtual communication tool for handovers and meetings, enabling them all to keep updated and overcome any challenges to maximise patient benefit.

They are also in the process of exploring a virtual exercise class via Microsoft Teams with the intention of expanding its cohort of patients and to provide a supportive environment and more tailored exercise programmes.

If you would like more information about this Virtual Pulmonary Rehabilitation service, please contact Nicola Zurawliw, Integrated Primary Care network lead, Specialist services, Rushcliffe Nicola.zurawliw@nottshc.nhs.uk or Julie Wooder, Head of Adult Community Services, Nottingham North & East - julie.wooder@nottshc.nhs.uk