Pulmonary rehabilitation (PR) reduces morbidity, mortality and hospital attendances in people with COPD disabled by their disease.

PR should receive commissioning priority given its proven clinical and cost effectiveness and relative value compared to many of our other interventions for COPD.

The more components of the COPD pathway work- ing together in an integrated multi-faceted pro- gramme, including an interface with self-manage- ment support, quit smoking support and oxygen assessment, the more likely there is to be a positive effect.

This paper reviews the evidence, explains what PR is, how it works, its value and why it should be com- missioned.

It supplements the Commissioning Pack for COPD to be issued by the DH England, including a section on PR (due early 2012).

It answers the questions asked by commissioners who may have no current service, a service with insufficient capacity, one that does not meet patient’s expectations, or one that is failing to achieve accept- able completion rates.