Quality and safety are the key themes for Allied Health Professionals Day 2024, emphasising the importance of providing exceptional care to the people and communities we serve.
Quality and safety are the key themes for Allied Health Professionals Day 2024, emphasising the importance of providing exceptional care to the people and communities we serve.
Working as Clinical Project Managers in the Cancer and Long-Term Conditions Team at NHS SCW are two Allied Health Professionals, Zoe Bristow and Karen Lock. Both are registered Physiotherapists with extensive respiratory experience, currently supporting the Gloucestershire Respiratory Service on its journey to Pulmonary Rehabilitation Accreditation.
Unless you have first-hand experience, you might not be entirely sure what Pulmonary Rehabilitation (PR) is. So, allow us to set the scene:
- Pulmonary Rehabilitation (PR) is a programme of exercise, education, and lifestyle support for people with long-term lung diseases (such as COPD, pulmonary fibrosis, or bronchiectasis) who experience breathlessness.
- It aims to help individuals better understand their lung conditions, manage symptoms more effectively, and improve their overall wellbeing.
- PR is run by a multidisciplinary team of healthcare professionals, including physiotherapists, nurses, dietitians, psychologists, exercise professionals, and support staff.
- It takes place in local hospitals, sports centres, community halls, and even online.
- Groups usually consist of 8-16 people, and the courses last about 6-8 weeks.
People First
Those invited to PR can usually choose between attending in-person group exercise and education classes or opting for an online version if that better suits their lifestyle. Before starting the programme, the PR team assesses participants' strength and exercise capacity, so exercises can be individually prescribed. The exercises are then progressively intensified throughout the programme to maximise benefits. They can also be adapted to accommodate other health conditions.
Optimising Care
PR has been shown to deliver significant benefits, reducing breathlessness, improving walking distance, enhancing daily activities, and boosting quality of life. It has also proven beneficial for the NHS by reducing hospital admissions, shortening stays for those admitted, and lowering the need for GP visits.
So, if it's so great, why did NHS SCW need to get involved?
Well, despite its well-documented benefits, PR services face challenges. They have long struggled with limited capacity and staffing shortages, leading to only a small number of eligible patients being referred to the services.
Furthermore, until recently, there were no clear benchmarks or standards defining what a "good" PR service should look like. This led to variations in service quality across the country, and even within local areas.
Quality
In 2018, the Royal College of Physicians (RCP) launched the evidence-based Pulmonary Rehabilitation Services Accreditation Scheme (PRSAS) to improve the quality of PR services throughout the UK. This programme has been well-received, with over 150 Pulmonary Rehabilitation services now either accredited or on their way to accreditation. NHS SCW was approached by Gloucestershire integrated care board (ICB) to support their PR service in preparing for PRSAS accreditation.
Gloucestershire recognised that while improving PR services was crucial, their clinical and operational staff were stretched thin and would struggle to prioritise the PRSAS process. Our role was to act as a critical friend, guiding and supporting the PR team on their journey toward accreditation.
We worked collaboratively to determine how and where we could add value to the team and to the people who needed their services.
A key part of our success was our ability to empathise with the team – clinician to clinician – regarding the challenges they faced in delivering high-quality care to all those who could benefit from it.
We helped alleviate the pressure on the team. We supported them in understanding the standards, conducted a stocktake of all their documentation, processes, and procedures, and catalogued everything. We reassured them that they were already doing great work, while also identifying areas for improvement. We embedded a Quality Improvement approach into their service development and operational planning. Additionally, we provided practical support, producing updated versions of key documentation to ensure alignment with PRSAS requirements.
A highlight of our support to the Gloucestershire team was the delivery of PR annual review days. These events enabled the entire team to come together, creating space for them to develop a shared vision for the service and agree on future areas for improvement. This dedicated time helped reinvigorate the team and gave them the direction needed to advance their service.
We are currently busy uploading all the PRSAS evidence for assessment, with plans to request an evaluation by the end of 2024.
NHS SCW have been invaluable. Zoe Bristow has predominately been our clinical project manager for the work we are undertaking. Her extensive clinical health care experience has provided balance of clinical background and health understanding, with strong project management skills which has driven the work forwards hugely. This has meant that her support has been efficient, and we have managed to keep to target. I have found the team to be accessible, responsive, dynamic within the project. I would highly recommend Zoe and her colleagues. - Liz Mount, Clinical Lead, Gloucestershire Respiratory Service
The NHS SCW team have given professional, valuable support to our Community Pulmonary Rehabilitation Team to enable them to implement continuous service improvement projects resulting in the team being in a place where they can submit for PR Accreditation! The progress the team has made over the past year has been amazing! The NHS SCW team not only gave structure and focus but gave the team confidence that working together they could rise to this challenging piece of work. As an ICB we are very pleased that we commissioned NHS SCW and would not hesitate to recommend them to others embarking on a similar demanding project. - Gina Mann, Senior Project Manager, Gloucestershire ICB
