Enya Daynes: Patient safety and PRSAS

As of February 2024, I became the new Quality Lead for the Pulmonary Rehabilitation Services Accreditation Scheme (PRSAS), and in this role I hope to support service to provide high quality care for patients. Accreditation can ensure that patient safety is maintained and that the staff delivering the service have the skills and competence to guarantee a high standard.

Pulmonary rehabilitation services deliver individually prescribed and tailored exercise to patients, supplemented by a programme of education to support the management of their disease. It is a highly effective intervention; however it is subject to some challenges in relation to patient safety. There are over 195 separate Pulmonary Rehabilitation services in the United Kingdom according to the latest report from the National Respiratory Audit Programme (formally National COPD Audit Programme). As with many other areas, these services have diversified in their delivery in order to meet demand and the evolving needs of the population. As a result, Pulmonary Rehabilitation can be delivered across various venues ranging from hospital-based classes, fully equipped gyms to minimally resourced community centres. This can present a challenge for patient safety, and it is key that services appropriately assess the suitability of patients and the venues in which they provide Pulmonary Rehabilitation, whilst still maintaining clinical effectiveness. The PRSAS ensures that risk assessments are completed for venues, and individual risks are assessed for patients.

Beyond this, the PRSAS ensures that centres have the appropriate support from the leadership team, and that they are adequately staffed to deliver the programme safely. As Pulmonary Rehabilitation is delivered in a class environment, with multiple patients with individual and specific needs, it is important that staff ratios are maintained in line with the British Thoracic Society Quality Standards, ensuring a ratio of 1:8 staff: patient ratio but a minimum of two members off staff at all times (one qualified healthcare professional).

Patient safety is at the heart of the PRSAS, and we continue to develop our standards as the Pulmonary Rehabilitation landscape changes, paying consideration to changes in workforce and service delivery. This is vitally important as services expand to meet demand, in line with the direction of the NHS long term plan to increase provision of rehabilitation services, which was supported by latest commissioning briefings.

• NHS England: Pulmonary rehabilitation
• NHS Long Term Plan