Evidence Requirements

• Evidence of patient/carer involvement in the running and development of the service (for example minutes of focus groups or meetings).

Guidance

• Information about how a shared common purpose is established with patient/carer groups.

Evidence Requirements

• Evidence of all staff attending dignity and respect training.
• A SOP for the service, including information on:
  • service approach to privacy, dignity and respect
  • patient security
  • managing belongings.

Guidance

• The procedures should be developed to safeguard the rights, privacy, dignity, confidentiality and security of patients/carers at all times, especially during subjective parts of initial and discharge assessment.

Evidence Requirements

• Section in SOP describing patient responsibilities.
• Anonymised patient letter examples.

Guidance

• This must include:
  • keeping appointments
  • notifying the service of appointment changes or cancellations
  • discussing with the service desired changes or decisions to terminate treatment and/or care
  • discussing with the service where expectations of treatment and/or care are not being met
  • abiding by any codes of conduct (eg zero tolerance for aggressive behaviour) or patient charters.

Evidence Requirements

• DNA management procedure for the service (in SOP).
• Evidence that DNA rates are reviewed and actions to improve performance are discussed at meetings regularly.

Evidence Requirements

All nations

• Waiting times and completion data for all patients.
• Evidence that waiting time and completion data for all patients are regularly scrutinised and effective action plans are in place to improve performance against local and national targets (where these exist).

England and Wales

• Evidence of meeting national median for:
• % of patients with stable COPD enrolled within 90 days of referral
• % of patients referred following hospitalisation for acute exacerbation of COPD (AECOPD) and enrolled within 30 days of referral
• % of COPD patient completion rates as evidenced by patients attending a discharge assessment and receiving a written discharge exercise plan, or
• evidence that waiting time and completion data are regularly scrutinised, and action plans are in place to improve performance against national targets.

Evidence Requirements

• Procedure to review and communicate inappropriate referrals to the referrer.
• Evidence of implementing methods to reduce inappropriate referrals.

Evidence Requirements

• A SOP for the service, including a section on transition care.
• Evidence that all individuals completing PR are provided with an individualised written plan for ongoing exercise, (discharge exercise plan) after leaving the programme.
• Evidence of discharge exercise plans being co-produced with patients/carers.
• Evidence of the promotion of self-management.

Guidance

• Evidence of links and referral pathways to community-based opportunities.
• The service identifies, makes patients aware of and encourage access to, local and national patient support groups and provides access to information to support patients manage their condition.

Evidence Requirements

• A SOP on care plans and promoting joint decision making (evidencing care/treatment plans are co-produced with patients/carers), and references to other care policies and protocols.
• Evidence that the service supports families and carers when they are involved in patient care.
• Evidence that all patients undertaking PR receive an aerobic exercise programme, which is individually prescribed and progressive.
• Evidence that all patients undertaking PR receive a resistance training exercise programme, which is individually prescribed and progressive.
• Evidence that patient knowledge/learning needs assessment has been undertaken.

Guidance

• These are fundamental aspects of care for any patient, including:
  • relationships with key staff
  • communication
  • ensuring comfort, alleviating pain
  • promoting independence.

Evidence Requirements

• Patient/carer survey template covering:
  • space/facilities/equipment during both assessments and PR classes
  • privacy, dignity and respect
  • involvement of the service user in their treatment/care
  • quality and clarity of information provided.
• Patient/carer survey data/completed surveys (anonymised).
• Actions plans (minutes of meetings showing evidence of patient/carer feedback discussions with agreed actions taken).
• Details of changes made in response to patient/carer feedback (eg you said, we did).
• Evidence of how the service gives feedback to patients/carers who have shared their views.

Guidance

• These procedures should include at a minimum feedback on:
  • quality and safety of treatment and/or care provided
  • involvement of patients in their treatment/care
  • quality and clarity of information provided
  • dignity, respect and compassion
  • all aspects of the patient pathway including referral and assessment
• Staff members should explain these feedback procedures to patient/carers.
• Staff members should be notified of positive feedback from patients/carers.
• Actions taken and improvements made by the service in response to patient/carer views should be offered to patients/carers who have provided feedback.

Evidence Requirements

• A SOP and policy on managing complaints
• Examples of concerns/complaints (eg anonymised complaints log), actions taken, dissemination methods and learning from feedback/concerns/complaints.

Guidance

• The service has processes in place to ensure complaints are reported, investigated, recorded and analysed with findings disseminated to relevant parties and acted upon.