1. HOPE SPECIALIST SERVICE
PULMONARY REHABILITATION PROGRAMME
AUDIT 2014/15
All figures and comments are taken from audit data and Pulmonary Rehabilitation
patient feedback forms completed between 1st April 2014 and 31st March 2015

2. CLINICAL AUDIT RESULTS – WALKING TESTS
2014-15 (n = 137) 2013-14 (n=114)
Pre Post Difference % Diff Pre Post Difference % Diff
Incremental Shuttle Walk
Test (ISWT) 144 203 59 141% 176 258 82 147%
Endurance Shuttle Walk
Test (ESWT) 205 523 318 255% 277 804 527 290%
(Clinically significant increase in walking distance = 47.5 metres)
Although the average increase in metres walked
appears to have decreased significantly in the year
2014/15, expressed as a percentage increase there is
little difference in the ISWT results and the ESWT
results still represent an increase in distance walked
of over 2.5 times.
Particularly excellent results were achieved with the
patients (n=28) who presented at pre-test with the
lowest level of exercise tolerance . These patients
achieved a 330% increase in the ISWT (36 metres to
119 metres) and 402% in the ESWT (67 metres to
269 metres).

3. CLINICAL AUDIT RESULTS – WALKING TESTS
2014-15 2013-14
Walking
Test Level
No. of
patients
Cumulative
total
% of total
patients
Cumulative
%
No. of
patients
Cumulative
total
% of total
patients
Cumulative
%
1 28 28.00 20.44 20.44 23 23 20.18 20.18
2 19 47.00 13.87 34.31 9 32 7.89 28.07
3 16 63.00 11.68 45.99 14 46 12.28 40.35
4 15 78.00 10.95 56.93 6 52 5.26 45.61
5 11 89.00 8.03 64.96 7 59 6.14 51.75
6 19 108.00 13.87 78.83 14 73 12.28 64.04
7 14 122.00 10.22 89.05 10 83 8.77 72.81
8 6 128.00 4.38 93.43 6 89 5.26 78.07
9 3 131.00 2.19 95.62 12 101 10.53 88.60
10 1 132.00 0.73 96.35 3 104 2.63 91.23
11 0 132.00 96.35 4 108 3.51 94.74
12 2 134.00 1.46 97.81 1 109 0.88 95.61
13 2 136.00 1.46 99.27 4 113 3.51 99.12
14 0 136.00 99.27 0 113 0.00 99.12
15 0 136.00 99.27 1 114 0.88 100.00
16 1 137.00 0.73 100.00 0 114 0.00 100.00
TOTAL 137 100 114 100
Further analysis of the data for the last two years (see table
below)shows that significantly more patients who completed the
programme in 2014/15 were at the lower end on the exercise
tolerance scale at pre test (where level 1 is the lowest exercise
tolerance). Average pre and post test walk figures are therefore
significantly lower until expressed as a percentage.

4. CLINICAL AUDIT RESULTS – CHRONIC RESPIRATORY
QUESTIONNAIRE
CRQ – an increase of 0.5 = clinically significant effect
2013-2014 Dyspnoea Fatigue
Score Pre Post Diff n= Pre Post Diff n=
1 to 2 1.61 2.95 1.34 54 1.57 3.17 1.6 19
2.01 - 4 2.88 3.76 0.88 51 3.23 4.08 0.85 63
4.01 - 7 4.91 4.3 -0.61 10 5.08 5.31 0.23 33
Emotion Mastery
Score Pre Post Diff n= Pre Post Diff n=
1 to 2 1.78 3.02 1.24 8 1.75 2.6 0.85 5
2.01 - 4 3.28 4.39 1.11 43 3.12 4.64 1.52 41
4.01 - 7 5.22 5.57 0.35 64 5.32 5.67 0.35 66
Score
1 Extremely short of breath
2 Very short of breath
3 Quite short of breath
4
Moderate shortness of
breath
5 Some shortness of breath
6 A little shortness of breath
7 Not at all short of breath
2014-2015 Dyspnoea Fatigue
Score Pre Post Diff n= Pre Post Diff n=
1 to 2 1.61 2.97 1.36 86 1.64 3.39 1.75 37
2.01 - 4 2.79 4.00 1.21 58 3.12 4.01 0.89 74
4.01 - 7 4.2 5.4 1.2 1 4.87 5.12 0.25 34
Emotion Mastery
Score Pre Post Diff n= Pre Post Diff n=
1 to 2 1.74 3.42 1.68 10 1.79 4.11 2.32 14
2.01 - 4 3.30 4.56 1.26 68 3.32 4.65 1.33 61
4.01 - 7 5.17 5.62 0.45 67 5.31 5.76 0.45 70

5. CLINICAL AUDIT RESULTS - HADS SCORES
ANXIETY 2014/15 2013/14
Pre Post Diff Pre Post Diff
Normal (0-7) 3.89 3.88 -0.01 (n=75) 4.02 3.64 -0.38 (n=66)
Mild (8-10) 9.06 7 -2.06 (n=32) 8.92 7.63 -1.29 (n=24)
Moderate (11-14) 12.26 9 -3.26 (n=27) 12.28 8.89 -3.39 (n=18)
Severe (15-21) 16.7 12.1 -4.6 (n=10) 16.67 12.33 -4.34 (n=6)
DEPRESSION 2014/15 2013/14
Pre Post Diff Pre Post Diff
Normal (0-7) 4.35 3.84 -0.51 (n=92) 4.03 3.5 -0.53 (n=76)
Mild (8-10) 8.97 5.67 -3.30 (n=33) 8.69 6.04 -2.65 (n=26)
Moderate (11-14) 12 7.6 -4.40 (n=15) 11.75 7 -4.75 (n=8)
Severe (15-21) 15.75 11.75 -4.0 (n=4) 15.75 10 -5.75 (n=4)

6. CLINICAL AUDIT - COPD
ASSESSMENT TEST (CAT)
2014-15 2013-14
Pre Post Difference Pre Post Difference
Impact Level
Normal (0-5) 3 3 0 (n=1) 5 7 +2 (n=3)
Low (6-9) 8.33 9.33 +1 (n=3) 7.83 8 +0.17 (n=6)
Medium (10-20) 16.59 15.33 -1.26 (n=51) 16.64 15.39 -1.25 (n=36)
High (21-30) 25.19 21.84 -3.35 (n=67) 25.35 20.87 -4.48 (n=53)
Very High (31-40) 33.45 24.77 -8.68 (n=22) 33.56 26.69 -6.87 (n=16)
CAT – clinically significant improvement is a reduction of 2

7. 2014/15 2013/14 2012/13
Do you think the programme was:
Too long 1% 1% 2%
About right 77% 82% 82%
Too short 22% (n=132) 17% 16%
Was the programme what you were expecting?
Better 70% 74% 72%
As expected 30% 25% 27%
Worse 0% (n=126) 1% 1%
How have the exercises helped?
Very much 54% 51% 53%
Quite a Lot 38% 45% 42%
Not much 8% 4% 3%
Not at all 0% (n=130) 0% 2%
Did the education help?
Very much 39% 48% 43%
Quite a lot 52% 46% 53%
Not much 9% 6% 4%
Not at all 0% (n=130) 0% 0%
Pulmonary Rehab Feedback Results
1st April 2014 – 31st March 2015

8. 2014/15 2013/14 2012/13
Washing
Better 44% 36% 55%
No change 55% 62% 44%
Worse 1% (n=133) 2% 1%
Shopping
Better 37% 41% 55%
No change 61% 49% 43%
Worse 2% (n=129) 0% 2%
Preparing meals
Better 34% 25% 38%
No change 66% 74% 61%
Worse 0% (n=128) 1% 1%
Cleaning (hoovering, making beds etc)
Better 39% 38% 40%
No change 59% 61% 56%
Worse 2% (n=125) 1% 4%
HOW HAS PULMONARY REHAB
AFFECTED YOUR LIFE?

9. 2014/2015 2013/14 2012/13
Social Life (e.g. going out, talking to people)
Better 43% 44% 48%
No change 55% 56% 51%
Worse 2% (n=132) 0% 1%
Confidence
Better 62% 66% 76%
No change 37% 34% 24%
Worse 1% (n=132) 0% 0%
Day to Day Life
Better 66% 68% 67%
No change 34% 32% 31%
Worse 0% (n=132) 0% 2%
How do you feel your bad days are now?
Better 63% 56% 72%
No change 35% 42% 27%
Worse 2% (n=133) 2% 1%
Many of you have had exacerbations (chest infections). How have these been?
Better 40% 39% 55%
No change 55% 57% 45%
Worse 5% (n=129) 4% 0%

10. 2014/15 2013/14 2012/13
Have you any feelings about your recovery times?
Better 70% 70% 79%
No change 29% 28% 20%
Worse (n=128) 1% 2% 1%
Have you surprised yourself during the course?
Very Much 54% 46% 39%
Quite a Lot 37% 46% 56%
Not Much 8% 6% 4%
Not at all (n=134) 1% 2% 1%
Have your family/friends noticed any changes?
Very much 36% 25% 34%
Quite a lot 44% 48% 44%
Not much 14% 20% 15%
Not at all (n=129) 6% 7% 7%
Generally, how do you feel now?
A lot better 57% 68% 70%
Slightly better 36% 26% 25%
No change 6% 4% 5%
Slightly worse 1% 2% 0%
A lot worse (n=134) 0% 0% 0%
Will you be attending Pulmonary Rehab Plus?
Yes 39% 48% 57%
Possibly 41% 41% 32%
No (n=128) 20% 11% 11%

11. 2014/15 2013/14 2012/13
Would you consider using a leisure centre?
Yes 20% 21% 25%
Possibly 30% 21% 23%
No (n=128) 50% 58% 52%
Do you intend to continue exercising at home?
Yes 88% 93% 89%
Possibly 10% 6% 8%
No (n=127) 2% 1% 3%
THE BUDDIES:
How important were the Buddies in:
Your decision to take part in the Rehab programme?
Essential 33% 34% 29%
Very important 43% 35% 47%
Important 14% 21% 20%
Not very important 5% 5% 2%
Not at all important (n=129) 5% 6% 2%
Decreasing your anxiety about exercise?
Essential 22% 26% 21%
Very important 52% 45% 54%
Important 22% 24% 21%
Not very important 3% 5% 1%
Not at all important (n=130) 1% 0% 3%

12. 2014/15 2013/14 2012/13
Motivating you during the programme?
Essential 27% 29% 28%
Very important 54% 47% 51%
Important 14% 24% 16%
Not very important 4% 0% 2%
Not at all important (n=130) 1% 0% 3%
Making you feel safe during the programme?
Essential 34% 30% 33%
Very important 44% 52% 52%
Important 18% 17% 14%
Not very important 3% 1% 0%
Not at all important (n=132) 1% 0% 1%
Contributing to a relaxed and friendly atmosphere
Essential 46% 40% 46%
Very important 42% 48% 44%
Important 10% 11% 9%
Not very important 1% 1% 0%
Not at all important (n=132) 1% 0% 1%
Acting as a positive role model for you?
Essential 39% 34% 43%
Very important 43% 47% 46%
Important 16% 18% 9%
Not very important 1% 1% 0%
Not at all important (n=131) 1% 0% 2%

13. 2014/15 2013/14 2012/13
Overall, how important do you feel the Buddies are to the success of the programme?
Essential 56% 57% 60%
Very important 33% 33% 34%
Important 10% 10% 6%
Not very important 1% 0% 0%
Not at all important (n=132) 0% 0% 0%
Were you able to talk to the Buddies about matters which you would not have felt
comfortable discussing with a health professional?
Yes 77% 88% 87%
No (n=128) 23% 12% 13%
Would you consider becoming a Buddy yourself?
Yes 20% 30% 26%
No (n=122) 80% 70% 74%
Overall how satisfied were you with your experience of the Pulmonary Rehabilitation
programme?
Very satisfied 91% 95% 92%
Quite satisfied 8% 5% 7%
Neutral 1% 0% 0%
Quite dissatisfied 0% 0% 0%
Very dissatisfied (n=130) 0% 0% 1%
Do you feel that you were treated with dignity and respect during the programme?
Yes 100% 100% 99%
No 0% 0% 1%

14. COMMENTS ABOUT THE EXERCISE
Can walk about much better
I have so much more energy after exercises which makes me feel
happier
Coming to Hope Street has helped a lot and I would recommend
it to anyone I think I could do with more rehabilitation
Did not want the exercises to stop I think my breathing has improved
Didn't know what to expect
In general, the course whilst not improving my overall health, has
nevertheless been beneficial in my opinion
Enjoyed coming - very helpful
It felt good that I was sharing my experience with other people like
me
Enjoyed every bit of programme It helped a lot
Enjoyed very much It helps you know what you can do
Everyone has done a fantastic job Members of staff make it pleasurable during course
Excellent and caring staff and buddies Nice relaxed atmosphere
Excellent facilities, staff excellent
Problems at the moment with medication - makes more breathless
than usual
Excellent programme with lots of help Programme too short but enjoyed
Feel a lot better than used to
Really enjoyed my time here, wish it had been longer, did me so
much good
Feels good in himself after coming here The programme was very helpful
Felt good in gym
The staff have been fantastic in helping me come to terms with
COPD. Friendly atmosphere, thank you.
Good job
The staff have been friendly, helpful and knowledgeable. I can't
fault their determination and dedication
Help how to breathe better Thoroughly enjoyed it
I can walk mostly without walking stick. I've straightened up
more, more confident outside walking Too early to have a definite opinion
I enjoyed every minute of the programme
Very enjoyable, much relaxing, the people who helped me a good
crowd
I feel I have become stronger and become more aware of my
breathing through the course Very good course, helpful for people who do not know what to do
I feel more energetic than I did. It has also helped with my
breathing Very productive and enjoyable experience
I feel my condition is better now Very professionally done
I had no expectations about the programme as I was totally
unaware of what it included/comprised of

15. HOW THE EDUCATION TALKS HELPED
Although just going over things already know Learnt quite a lot of new things
Correct way of breathing Looked forward to coming
Especially breathing techniques Some very useful tips
Forgot as soon as came out Some were interesting, some I found a bit boring
Glad I came Sorry I didn't hear all that was being said
Had some very good advice Staff very helpful
Help to breathe better, clear chest, know when to
take a break Talks not always appropriate to my needs
I believe I will benefit from it Talks were very interesting
I enjoyed my course and already feel the benefit
The education sessions were extremely helpful and covered topics
which were delicate in deliverance
I looked forward to coming to Hope Street. I am
sure it has helped some. The education was very helpful and useful
Informative Very helpful
Interesting Very interesting
It taught me a lot Very interesting
It was all very informative Well done
Learned a lot

16. HOW THE BUDDIES HELPED
A very nice group of people Given me more confidence
Recognise you when you come in the door, so friendly
and helpful. They know how you feel
All very helpful, did not make you feel pushed
Giving me the encouragement to cope with my
COPD They always help
Always got a smile on their faces and offer
plenty of encouragement
Helped me see that life can be better,
improved
They are always asking if you need any help, which is
essential
Always ready to help with the equipment Helped right through the programme They are great
Assurance during exercises Helped to make me feel confident and cheerful They do a wonderful job
Being cheerful
I don't think they could have done more than
they did
They have been there for support which I have
appreciated
Being sociable
I took them as an example of what could be
achieved They have talked me through all my exercises
Being there for me Just being a friend They helped me with my walking and other exercises
Being there for you Just being available
They helped create a comfortable and happy
atmosphere
Breathing Just being there
They hold conversations at the table when you are sat
on your own
By making me feel relaxed and enjoying the
exercises Just talking
Understanding my illness better. The health
professionals diagnose you but do not follow up with
the realities/consequences of your illness. The buddies
are "real life" examples of the illness and can relate to
issues that matter to me
Calm when breathless Made me more confident Very friendly and encouraging personalities
Chatting
Made you feel comfortable knowing they they
have been through the same Very friendly and supportive as indicated above
Confidentiality Motivation Very friendly people
Could ask them anything - very helpful Not really Very friendly, just like a happy family
Done everything possibly could Put me at ease and very considerate Very helpful
Every way, acceptance of COPD condition Put me at ease, could not wish for more Very kind and always easy to approach
Give good advice on techniques Putting on weights etc
Without the buddies filling in my forms and staying
with me I could not have been able to come

17. PATIENT COMMENTS ABOUT THE PROGRAMME
A very worthwhile experience with
friendly caring people who are
experienced in my disability Fantastic programme It's very interesting
All fantastic First class service and good friendly staff
I've learned a lot of comments, which have
helped me, mentally and physically
All staff and buddies been very helpful
and warm Good programme,well worth doing Marvellous staff
All staff very helpful, very glad I was
asked to participate, wished I could have
come sooner Helpful and enjoyable course
People here take interest in you when
others sometimes don't. Don't know where
I'd have been without Hope St.
An enjoyable programme with very
friendly staff, very helpful Highly recommend the programme
Programme very good, though some of the
time spent during talks is not well spent, e.g.
talks about smoking etc
An excellent worthwhile programme
I am very pleased with the PR
programme and feel a lot better
Should be an introduction to the course, for
say the first session, exampling the
education sessions and exercise programme.
It would be less daunting than turning up
and "getting stuck in"
Anybody with the condition should
attend I enjoyed it very much Staff are brilliant
Best thing that has happened to me
during my treatment
I feel it would be more beneficial at
another time when not having problems
with breathing tablets, which are making
me poorly
Super, really enjoyed from start to finish.
Lovely staff and buddies helped me no end
Brilliant
I feel very fortunate to have had the
opportunity to participate in the
programme. Friends in other areas have
not been able to do this!
Thank you for being there for me and all the
other people with breathing problems

18. PATIENT COMMENTS ABOUT THE PROGRAMME
Do a very good job. Very helpful
I feel very grateful at being here. Thank
you.
This was a brilliant way of coping
with my illness and not being too
frightened
Enjoyed it all, has been terrific, would
recommend to anyone I have enjoyed the programme
Treated as an equal even with extra
medical problems
Enjoyed it and felt the benefit
I recommend it to everyone with this
disease V.G.
Enjoyed it, staff and everyone very good I think it's just great Very good
Every person I came into contact with was
100% caring and professional
I thought everybody was very helpful and
wish I had known about it sooner.All the
staff and buddies gave you confidence Very good
Everybody has been fantastic towards my
health. They were brilliant I would just like to thank everyone Very good and worthwhile
Everybody made you feel welcome and
helped you progress
I would recommend anyone with COPD or
breathing problems, if given the chance,
to attend to take full advantage.
Very good for all problems with
breathing
Everybody very helpful and friendly
Invigorating, sometimes informative but
quite enjoyable to a point
Very good, the staff and the buddies
were helpful and made one feel
relaxed
Everyone was brilliant
It is a good programme, well monitored
and of benefit to patients Very good, would do it all again
Everyone was very helpful and offered
plenty of advice and encouragement. And
the lectures were very good.
It is a scheme that should continue
because they do help
Very impressed with how well
organised
Excellent- only improvement would be
evening and weekend sessions It was a good thing to do for me Very lucky to have one
Excellent programme
It's a very friendly and relaxed
atmosphere. Great
Very pleased to have been taking
part
Fantastic help. Loved every minute!
It's a wonderful programme and has
helped many, many people. I thank
everyone for their hope
Would recommend anybody to the
programme