Quality statement 3: Supervised exercise programmes

Quality statement

People with intermittent claudication are offered a supervised exercise programme.

Rationale

Supervised exercise programmes can improve walking distance and quality of life for people with intermittent claudication. However, the provision of services varies across the country and so there is a need for both new provision and improvement in existing care.

Quality measures

Structure

Evidence of local arrangements to ensure the availability of supervised exercise programmes.

Data source: Local data collection.

Process

(a) Proportion of people with intermittent claudication who are offered a supervised exercise programme.

Numerator – the number of people in the denominator offered a supervised exercise programme.

Denominator – the number of people with intermittent claudication.

Data source: Local data collection. Contained within NICE clinical guideline 147 audit support – imaging and supervised exercise programmes: audit standard 3.

(b) Proportion of people with intermittent claudication who start a supervised exercise programme.

Numerator – the number of people in the denominator starting a supervised exercise programme.

Denominator – the number of people with intermittent claudication offered a supervised exercise programme.

Data source: Local data collection.

(c) Proportion of people with intermittent claudication who complete a supervised exercise programme.

Numerator – the number of people in the denominator completing a supervised exercise programme.

Denominator – the number of people with intermittent claudication who start a supervised exercise programme.

Data source: Local data collection.

Outcome

(a) Improvement in pain-free walking distance.

Data source: Local data collection.

(b) Improvement in health-related quality of life.

Data source: Local data collection.

What the quality statement means for service providers, healthcare practitioners and commissioners

Service providers ensure the availability of a supervised exercise programme for all people with intermittent claudication.

Healthcare practitioners ensure that they offer supervised exercise programmes to all people with intermittent claudication.

Commissioners ensure that they commission supervised exercise programmes that can be offered to all people with intermittent claudication.

What the quality statement means for patients, service users and carers

People who have pain when walking because of poor circulation are offered a supervised exercise programme to gradually build up their pain-free walking distance and improve their quality of life.

Source guidance

  • Lower limb peripheral arterial disease (NICE clinical guideline 147), recommendation 1.5.1 (key priority for implementation).

Definitions of terms used in this quality statement

Intermittent claudication is defined as a walking- or exercise-induced pain in the lower limbs caused by diminished circulation. [Full NICE clinical guideline 147]

Supervised exercise programmes may involve the following components:

  • 2 hours of supervised exercise a week for a 3‑month period

  • encouraging people to exercise to the point of maximal pain.

[Adapted from recommendation 1.5.2 of NICE clinical guideline 147]