Digital Transformation and Beyond in Pulmonary Rehab

During the past year the NHS has been celebrating its 70th birthday. On reflection it is scary to think that I have actually been working for the organisation for half its life and more than half mine – I will leave you to do the maths!

When I began my working life I had never considered that the NHS was a relatively young organisation or how people managed their health before its existence.

As a physio with…… years of experience I have been fortunate to work in a variety of area both geographically and clinically.

Working with people living with a lung condition is the area that I feel most passionate about. Reflecting before writing this blog I wondered if this passion began when as a child we spent a lot of time with grandpa who had chronic bronchitis now known as COPD.

jm pr 2018 grandpa

He was an amazing proud man who worked as a structural engineer, in a building company in Kilmarnock and who always put his family first. He loved nothing better than having his family around him telling us stories about his life. The friends he had made  he played hockey when studying a Cambridge, The building work he did in the army in the second war, building the Mulberry floating harbours for the D day landings and working with the Commonwealth war graves commission after the war in France.

He had smoked most his life right until he passed away – including when he was using oxygen!

Grandpa’s last few years in the 70s were mainly spent in bed with constant oxygen, people with chronic bronchitis stayed in bed as activity  made them cough. My Dad still tells the story that when his oxygen ran out he was sent to the building yard for another cylinder!! I often remember grandpa saying if he didn’t have chronic bronchitis he would love to watch his grandchildren playing their various sports.

He only left the house to go into hospital in an ambulance which happened several times a year and was in for weeks at a time – one of the pavilions of at Ayrshire Central Hospital. Despite being a strong willed educate person he would never question the medications the doctors prescribed or consider looking for information that would help him. He was ill so he stayed in bed. Self management to him was doing as the doctors ordered.

He passed away at Ayrshire Central Hospital. We were not allowed to visit him and just waved through the window.

Pulmonary rehab was just beginning in this decade and not available in Ayrshire. As evidence was gathered we now know that Pulmonary rehab is the best non pharmacological intervention to help people living with COPD after stopping  smoking and  ensuring that the flu vaccination is taken.

  • People who have completed pulmonary rehab have
  • fewer chest infections,
  • are more physically active
  • Confident in managing their breathlessness
  • Understand how best to manage flare ups
  • Spend less time in hospital and are less likely to be readmitted
  • Can increase life expectancy

jm pr 2018

There is now so much evidence of the benefits of pulmonary rehab that Cochrane review have asked that research now focuses on aspects comparisons different delivery methods.

Currently in Ayrshire and Arran by transforming services we have been able to invest in pulmonary rehab increasing our provision from 3 classes for Ayrshire to 7 classes. We are able to deliver classes closer to individuals home and when required in their homes. Trialling different technology to deliver Pulmonary rehab is the main focus of our current development work to help those patients unable to attend a class for a variety of reasons. We work closely with British lung Foundation and support the 3 local Breathe easy groups and our classes are supported by volunteers who have previously through the programme. Most importantly we are able to help people live well with their lung condition and remain as active as possible.

If grandpa had been in the same position now I hope he would have been:

  • Confident self manager,
  • Able to remain as active as possible visiting his family and able to watch us playing sports ,
  • Able to recognise the early signs of an exacerbation and take the correct steps to manage this without a hospital admission, and
  • Able to have a good death at home with the people he loved.

What will the next 70 years hold?

  • Will digital solutions be a thing of the past?
  • Will smoking related lung conditions be eradicated?
  • Will we be implanted with chips that automatically detect changes in our physiologically and change medication automatically allowing individuals not to notice a change and allowing them to remain active and independent
  • Will we be able to 3D print new lungs?

As long as individuals, health care professionals and health care developers continue to work together improvements will be never ending.

Thank you for reading my blog

joanna mowbray profileJoanna Mowbray

Physio Service Manager South Ayrshire HSCP







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