Simon Pearce has a number of lung conditions, including COPD, asthma and bronchiectasis. He first heard about the benefits of pulmonary rehabilitation in 2013 when he attended a Asthma + Lung UK Breathe Easy group in Darlington and was keen to learn whether he would be eligible. However, it took another three years and two moves, first to Dartford, then to Enfield before he found a consultant willing to put him forward for PR. “I’m not sure why, but specialists didn’t want to talk to me about PR,” Simon says.

In 2017 Simon finally attended a PR course run by NHS physiotherapists at a leisure centre in Enfield over six weeks. “PR has helped me,” Simon says. “I have been able to do more, which has meant I can get out of the house more often. I still get out of breath, but I recover quicker.” He says that through PR he has learned more about how to manage his health and he has not been admitted to hospital for more than a year. Simon’s GP in Enfield has suggested a second round of PR, which he is keen to pursue. Simon says: “PR has definitely helped me and I recommend other people with a lung condition ask their consultant about it.”

Homerton University Hospital in Hackney launched an initiative to encourage more people with lung disease to take part in pulmonary rehabilitation (PR). This followed publication of the National Clinical Audit of PR Service in England and Wales in February 2016. The audit showed that many people who would benefit did not enrol in PR or dropped out before completing treatment, possibly put off due to long waiting lists.

Laura Graham, Respiratory Lead Clinician at Homerton and a specialist respiratory physiotherapist, says the national audit chimed with the hospital’s own PR experience. “The national audit was a turning point. We knew that there was a significant population who would benefit from PR, however either we could not reach them or we could not support them to complete treatment.”

Homerton has introduced a number of innovations, which include a psychologist attending PR classes once a week, offering support around the emotional challenges of PR and following up with patients who do not attend. In addition, a multi-disciplinary team hold a PR education session, which all referred patients attend before their PR assessment. This has resulted in improved attendance to the PR assessment and completion of the PR course.

The hospital has also introduced a lower level breathlessness rehabilitation group for the frailer people with more complex needs being referred. This group enjoys high levels of patient satisfaction despite some challenges, including the need to provide transport. This offers choice to patients who would otherwise be seen at home. 

John Turner never much rated his singing voice. So, he was intrigued when the Royal Brompton Hospital invited him to join an experimental singing group for patients with lung disease. Today, some 15 years later, the group is still going strong and Singing for Breathing is recognised as an effective non-pharmacological treatment for people with lung disease. A number of groups are established around the country, bringing together people with a lung condition who enjoy singing and also benefit from learning the breathing exercises.

“Music is an immensely powerful tool,” says John, 82, who lives with severe emphysema. “A positive mood is vital in illness and music creates that mood.” John, from south-west London, believes that Singing for Breathing is at least as valuable as pulmonary rehabilitation in terms of its impact. “Socially, it works at every level. You are coming together as a group and enjoying each other’s company while doing exercises that help you to manage your condition. You are with people who understand what it means to live with a lung condition and who support one another.”

Groups supported by Asthma + Lung UK have local leaders trained to lead singing groups for people with lung conditions. There are also independent singing groups.