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Improving and Integrating Respiratory Services in the NHS (IMPRESS)

IMPRESS is a joint initiative between the two leading respiratory clinical societies in the UK: the British Thoracic Society and the Primary Care Respiratory Society (PCRS) UK (previously the General Practice Airways Group). The site contains all you need to know to commission or provide high quality patient-centred services, integrated between primary and secondary care. The focus is on long term conditions such as COPD, asthma and sleep apnoea because these are the conditions most likely to require a mix of primary and secondary care over a person's lifetime. The website is designed to equip commissioners with an understanding of the evidence-base, standards, workforce issues, and tricky issues such as interpreting data and coding correctly.  Equally, it offers clinicians practical tools; an appreciation of how their services might be commissioned in the future, and suggestions of how they best engage with the commissioning process.   We appreciate that each UK nation has a different structure and ways of planning and procuring health services.  Since the changes that have created most desire for guidance and support have been in England, some of these pages are specific to England (the Commissioning pages in particular). However, we hope that colleagues in Wales, Northern Ireland and Scotland will find resources that help them too.  We also acknowledge that each nation has its own respiratory strategy in draft or published.  For further information and links please go to NHS Policy. 

This website is now getting about 400 visits a week.   Please let your clinical, managerial and commissioning colleagues know about  the site.


Quality and productivity: IMPRESS's More for Less

Keep up to date with NHS Policy: summary of Operating Framework and Outcomes Framework

BOOK NOW! 

Practical solutions to commissioning and providing high quality respiratory and end of life care.  Second IMPRESS conference

24 May 2011, Birmingham ICC. Download brochure, including details of IMPRESS Awards. Full programme information here


SHA Respiratory Programmes - See here for more information


IMPRESS Awards and models of good practice
We welcome submission of examples of good practice by 3 May 2011 to [email protected]. for consideration by an expert panel for the IMPRESS Awards.  Three winners in three categories and best overall runner-up will be announced at the IMPRESS conference on 24 May. More details download here.

Information about 2009 IMPRESS Award winners click here


 

Publications

The documents listed below are available to download (pdf format)

Rationalising oxygen use to improve patient safety and to reduce waste


 

Guide to information July 2010 - see news.

 


Guide to information about the use of medicines in the NHS A document about the information available to help clinicians, commissioners and managers to know what is being prescribed by whom, for whom, at what cost, and at what benefit.  7 July 2010.


More for Less 1 July 2010
Discussion paper to inform the implementation of respiratory strategies within the context of limited resources.


NHS Jargon Buster (3rd edition updated March 2010)
An essential glossary of NHS, housing and social care jargon. (Online version available here)

 


 Living and Dying with COPD is an educational package from IMPRESS consisting of a DVD and CD of PowerPoint slides. Free copies are available now.

 


IMPRESS Social Care and Housing Jargon Buster

 


Shaping the Future of Care Together The Big Care Debate - Response by IMPRESS

 



documentgifBidding for Community COPD Services - A second case study


 


  Service Specification for Investigation and treatment of Obstructive Sleep Apnoea Syndrome
 

 


 IMPRESS response to Department of Health (England) End of Life Care Strategy: Quality Markers Consultation

 


Best practice guidance on developing a respiratory service specification

 

 


Delivering Respiratory Care Closer to Home

 

 


Commissioning a community COPD service
Based on a case study in Somerset PCT by IMPRESS

  


A Vision for Respiratory Care
Our response to Lord Darzi.

 


Guide to respiratory coding
Published by the British Thoracic Society and compiled by Dr Steve Connellan, this guide to respiratory coding is an essential reference and includes HRG4 codes to be used from April 2009

 


Workforce standards

 

 


Consultant Physicians in Integrated Respiratory Care

 

 


Principles, Definitions & Standards for Pulmonary Rehabilitation

Supported by IMPRESS in consultation with BAOT, ARNS and ACPRC

 


BTS statement on criteria for specialist referral

 

 


Referral letter

Latest News

15 April 2011 During the Pause. Impressions 5 on Audit Commission reducing expenditure on low value treatments, the APHO general practice profiles and case-finding.

7 April 2011 New Impressions on hospital discharge from the Care Quality Commission and avoiding admissions in COPD and for older people

25 March Impressions - new IMPRESS blog on quality and productivity in primary care and avoiding admissions

21 March QOF points updated: slight change to COPD indicators and new points for quality and productivity.  See here.

10 March  BTS, in conjunction with Salford Royal Foundation Trust and Southend University Hospital Foundation Trust, have won the prestigious 2011 Patient Safety Award for Patient Safety in Clinical Practice for their work to improve safety in administration of emergency oxygen to adult patients out of 70 entries. Click here for more information.

10 March Two new additions to the good practice resources from Southend  - commissioning case for an extension to the community respiratory service funded by NHS South East Essex and also their submission to the Health and Social Care Awards, East Region for which they were highly recommended

8 March IMPRESS recommends two reports:  Avoiding hospital admissions.  What does the research evidence say?
Sarah Purdy, Kings Fund, December 2010 and Remote control: The patient-practitioner relationship in a digital age  NHS Confederation.  See here for IMPRESS Programme Manager commentary

8 March  David Nicholson's letter of 17 February to NHS including competition and choice principles

18 February - NHS London CQUINs for COPD and stop smoking

4 February 2011 - more information on social care financial allocations for reablement, and social care to benefit health eg crisis response, community equipment, falls prevention...

28 January 2011 -  call for good practice examples of psychological support.  Deadline 16 Feb 2011.  More

25 January 2011 - Lung Improvement Programme announces applications for national asthma improvement projects.  Deadline 4 March 2011.  Four themes: 1. Improving Asthma Diagnosis and Medicines Optimisation 2. Transforming Acute Care 3. Chronic Disease Management 4. Integrated Care Pathways  More..

25 January 2011  Oxygen update: too much oxygen may cause 2000-4000 avoidable deaths a year with COPD.  Go here for latest evidence and patient safety awards.

20 December NHS Outcomes Framework published following  the consultation Transparency in outcomes - a framework for the NHS with a number of respiratory disease indicators.  More analysis from IMPRESS.

20 December DH published the next phase of consultations: Liberating the NHS: Developing the Healthcare Workforce that sets out proposals for a new workforce, education and training structure driven by patient need and led by local healthcare providers. Consultation  closes  31 March 2011.

15 December  Liberating the NHS: Legislative Framework and Next Steps, published which sets out the policy for NHS Reform in detail including a timetable.  More detail.

15 December - Operating Framework for 2011/12 is published by DH England.  Click here for documents that include transitional commissioning arrangements from PCTs to GP consortia requiring PCTs to cluster into single executive teams by June 2011, confirmation that £20 billion to be found - but now over 4 years (to March 2015); requirement that PCTs "continue" the task of delivering the 24 recommendations of the Strategy for Services for Chronic Obstructive Pulmonary Disease (COPD) in England; hospital tariff to be set at an average 1 per cent below the cost to the average provider for the first time and providers will also be allowed to offer services at below tariff from April 2011. Full IMPRESS summary here.

8 December - summary of the Ernst and Young and RAND Europe independent interim evaluation of the 16 integrated care pilots in the NHS now available

8 December - DH England announces  52 'pathfinder' commissioning consortia covering 1,860 GP practices serving 12.8m patients. Updates will be found on the pathfinder learning network.

6 December - DH England  published the public heath white paper Healthy Lives, Healthy People for consultation on 30 November. Go here for immediate responses.

1 December - A vision for adult social care: Capable communities and active citizens and best practice guides launched on 15 November - summary here.

30 November - Dr Foster Good Hospital Guide 2010 including Hospital Standard Mortality Ratios - see Behind the Headlines report for patients and clinicians

29 November - new commissioning resources: national commissioning website Atlas of Variation and report from the Kings Fund Clinical and service integration: The route to improved outcomes.

29 November - summaries from IMPRESS Project Manager  of presentations by Mark Britnall, Earl Howe, Chris Ham and others taken at the recent NHS Alliance conference, as well as notes on personal health budget pilots. Click here.

17 November 2010 (World COPD Day): £800m savings identified through better COPD care  Health Service Journal 11 November 2010  IMPRESS response

15 November 2010  New generic commissioning toolkits for GP commissioners.  More...

15 November 2010 New adult social care guidance and consultations published from DH England including personal budgets.  Click here.

10 November 2010 NICE draft quality standards for COPD launched 30 September 2010 - consultation now closed.  click here

1 October 2010 - draft NICE quality standards issued for consultation  Click here

1 October 2010 - links to the BTS,RCP, RCGP, RCN  and BMA pages on the white paper Liberating the NHS (England) click here

13 September 2010 "...Here is our step-by-step improvement guide to oxygen services. If you follow these steps we would expect that you will improve care. You will also probably release savings that we hope you would negotiate with your local commissioner could be reinvested in implementing some of the other recommendations in the national strategy."   Click here to read the guide and all the practical appendices.

August 2010
  "...patients with COPD should be offered the most intensive smoking cessation intervention feasible, not only from a clinical but also from an economic perspective." [NHS Evidence on Thorax paper August 2010]. Click here for more information.

 

 


 Living and Dying with COPD is an educational package from IMPRESS consisting of a DVD and CD of PowerPoint slides. Free copies are available now and have been sent out to those people who registered an interest. For further information including a short film clip and to order a copy click here.  February 2009: We have also submitted a response to the end of life care quality markers consultation.  For a detailed explanation of the particular challenges of providing high quality end of life care for people with COPD click here.  June 2009: we have now issued over 3400 copies of the package, and it has been extremely well received. We are now working with a local clinical network led by NHS Bristol to understand how to embed  it in practice.

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IMPRESS is grateful to  its corporate supporters - AstraZeneca, Boehringer Ingelheim/Pfizer and GlaxoSmithKline who provide grants for this independent programme of study
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