To celebrate world physical therapy day 2023, we spoke with two respiratory physiotherapists working in pulmonary rehabilitation (PR) to bring awareness to the incredible impact they have on patients through their programmes. Christopher Dalton and Jonathan Lee gave us some insight into the different aspects of a working as a physiotherapist in pulmonary rehabilitation and the challenges that come with it!

It’s always a privilege talk to people passionate about their fantastic work in PR with a shared goal of helping improve patients’ quality of life.

Could you explain your role as a respiratory physiotherapist in pulmonary rehabilitation (PR)?

Jonathan: We run multiple sessions per week for the pulmonary rehabilitation patients, two being exercise related and one being education based. Our assessment of the patients is held both before and after the programme – this enables us to assess in both a qualitative and quantitative manner, as well as having a clear visual of their progress.

Christopher: For me, a lot of my job comes down to building that rapport with the patients. This is primarily getting know them, informing them of the benefits, increasing their exercise tolerance, and then developing individualised programmes tailored to their needs. A key aspect to this is helping them translate what they do in the class into their daily life and education. Having that education aspect is really important as hopefully we are inspiring a life change, as well as being just a phone call away if they have any concerns or flare-ups, which provides patients with a safety net.

 What is the most rewarding aspect of working as a respiratory physiotherapist in PR?

Jonathan: There is a lot of different branches to our line of work – the main one being improving patient wellbeing. Beyond their physical abilities, pulmonary rehabilitation also improves their mental wellbeing –and this causes their lifestyle to change significantly, which is really good to see.

For me, working as a team to improve patients well-being is also a great part of my role, not just with other physios but also with dietician, psychologists, and other professionals, as well as helping the patient to build links to their local community.

Christopher: Seeing the patient journey, in this role we see all parts of the spectrum. We see patients when they are really struggling and then hopefully see them at the end of their PR when they’ve made huge progress – when they know more about their conditions, and can self-manage, and hopefully we have helped them make lifestyle changes which they will carry on in life.

What is the biggest challenge you have faced as a respiratory physiotherapist so far?

Jonathan: I think the most unsurprising one is probably staffing, I’ve worked for the NHS for 10 years, and recruitment now is so much harder. As a result, the waiting times have to increase, because services don’t have the staff to run all the programmes, which can, understandably, be frustrating for the patients that are referred.  

Christopher: COVID was a massive challenge, especially the different aspects of balancing safety, and maintaining quality at the same time. We had to change the way we were working, to ensure the safety of patients which then had a knock-on effect, but we were able to look into the different options and figure out what was right for our patients.

I think the other challenge we are facing right now is accreditation, but that’s a good challenge! Making the time to embrace it and allow good positive change for your service and all the quality improvement projects we’ve done throughout the journey been brilliant.

How long have you been working in this field? What was your journey into this specialisation?

Jonathan: I did my junior rotations and spent five years doing five - six month rotations around the core areas of physio, and the most interesting ones to me where the ones relating to respiratory. After 5 years I became a senior physio in a cardio respiratory team, and that was a larger team, so it involved more respiratory work such as PR.

My job in terms of respiratory work involves having a lot of knowledge on respiratory conditions, I have gained a lot of extensive knowledge around these – in inpatient, ward based and now I am based in community in pulmonary rehabilitation.

Christopher: I have been a physio for the last sixteen years now, and thirteen of them have been respiratory. My mum had Parkinson’s, and she was diagnosed very young. I was her main carer during that time – unfortunately, things got worse, and she ended up in intensive care, where I saw the respiratory physios coming in – I was really intrigued.

I will never forget that the student physiotherapist at the time came over to be and gave me an information booklet on how to get into university to become a physiotherapist. So, at the time I was in insurance, I went back to college to do all my A levels, and then did four years total training. I knew my dissertation was going to be on respiratory and Parkinson’s because of my mum, so I was very driven.

 We’re aware there is a shortage of respiratory physiotherapists in pulmonary rehabilitation; how would you promote the profession to others? What is the best advice you have for someone looking to join?

Jonathan: I think as a student physio, you need to make sure you delve into all the correlations of physiotherapy. A lot of people as a student think they want to do MSK or base on a ward, but I think delve in deep with every rotation and you will learn bits from everyone, and you will eventually find your passion.

Christopher: I think a lot of physios still think MSK is the route that is thought to go down, however, as I’ve said, seeing the patient journey is so rewarding. Not only that but, PR opens up so many opportunities, there are the classes where you see people develop, and create individualised programmes, but it’s the stuff outside that in quality improvement projects, risk assessments and managing a whole service.

There is also a real team work approach to PR, you are working with OT, nurses, pharmacy technicians, dieticians, which is such great collaboration, and you get a nice holistic view for the patient.

Thanks to both Jonathan and Chris for their time and insight into working as respiratory physiotherapists in pulmonary rehabilitation, and we commend them for their fantastic work to improve patients wellbeing and quality of life!  

if you are interested in learning more about the PRSAS programme, click here. To get in touch with the PRSAS office, email pulmrehab@rcp.ac.uk