Delivery of Pulmonary Rehabilitation - SEL CCG

South East London Clinical Commissioning Group (SEL CCG) seeks to procure a Pulmonary Rehabilitation (PR) service from a single provider, for a three year period.

This service will be for the residents of the London Borough of Bexley with a diagnosis of COPD or other chronic respiratory condition.

The Small Medium Size (SME) Provider (with less than 250 employees) will need to be able to demonstrate a proven track record of delivering pulmonary rehabilitation services in South East London for a minimum of 3 years.

Based on current and historic levels of activity, the pulmonary rehabilitation should be completed by up to 290 Bexley patients each year.

The provider will need to work with the CCG to maximise value and manage the demand, such that waiting times remain acceptable, and the service operates effectively, targeting those who will most benefit.

The Pulmonary Rehabilitation service will be delivered as a combination of exercise and education classes over a 6 week period (patients attending twice weekly) or a 12 week period (patients attending once a week).

These classes should include the following: • Duration of aerobic exercise - initially aiming for 20-30 minutes of continuous exercise in each session, then increasing intensity once achieved; this may be comprised of two or more bouts of shorter time periods until the patient is able to achieve the desired 20-30 minutes continuous aerobic exercise.

An essential minimum of six weeks, with no maximum upper duration. • Strength training - both upper and lower limbs.

Core exercises should be included. • Education should include: o Normal Respiratory Physiology and mechanics • Understanding COPD/chronic respiratory diseases their pathophysiology, causes and treatment • How to equip the individual to improve confidence, self efficacy and self management • The roles of exercise and relaxation • Psychological impacts and minimising their effects • How to manage breathlessness - smoking and smoking cessation services if appropriate • The benefits of regular physical activity and exercise, and how to undertake physical activity and exercise safely and effectively