Introduction and objectives Pulmonary Rehabilitation (PR) should be made available to all suitable people with COPDand various other chronic respiratory conditions.1 Recommendations have been made on the quality of the provision and commissioning of PR. Indicative benchmark rates have been developed2 to support commissioners determine local need. We compared the local availability of PR across the EoE.
Methods A regional PR group was formed to promote best practice, offer peer support and enable improvements through the collection of meaningful regional data. Data was collected from 17/18 (94%) providers on the number of PR places commissioned per CCG(s). In 13 providers PR was commissioned. In 4 providers PR was provided under Payment by Result and in these maximum capacity was calculated using a 1:8 staff:patient ratio. Comparison was made between availability and indicative benchmark rates in each locality. Where providers covered more than one CCG, data was aggregated for analysis purposes.
Results In the EoE the average number of people expected to benefit from PR/year is 11,748 (192 per 100,000 population/year).3 However, our data showed a maximum of 6,165 PR places were available (101 per 100,000/year). Local provision varied 2.8-fold across the CCGs, ranging between 60 per 100,000/year and 171 per 100,000/year. This was not explained by local variation based on local need as actual provision/local target varied 3.1-fold [27.2%-85.4%].
Conclusions There was evidence of post-code lottery in the provision of PR with a 2.8-fold variation between localities. There was also an overall insufficient availability throughout the region (average 52.5% of the proposed target). Provision compared to local targets varied more than 3-fold. Provision was less than 50% of local target in 50% of localities. This data will be shared with local commissioners and providers, so that this deficiency can be addressed.
National Institute for Health and Clinical Excellence (NICE). COPD: management of COPD in adults in primary and secondary care. 2010 http://www.nice.org.uk/guidance/CG101
National Institute for Health and Clinical Excellence (NICE). Commissioning Guides: Services for people with COPD[http://publications.nice.org.uk/services-for-people-with-chronic-obstructive-pulmonary-disease-cmg43/44-commissioning-high-quality-integrated-care-for-people-with-copd] Accessed on 05/07/14
East of England Commissioning Framework 10/11.[http://www.ibyd.co.uk/bhf/documents/Strategic_Health_Authorities/East/CommissioningFramework1011.pdf] Accessed 04/07/14