BTSPCRS
HOMEABOUTUSCONTACTUS
  Search
Home
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: click here for More for Less


SHA Respiratory Programmes - See here for more information


IMPRESS Awards and models of good practice
The next round of IMPRESS Awards will take place in 2011.  Further information will be provided here in due course.    2009 IMPRESS Award winners  for Displaying Innovation in Integrated Primary and Secondary Respiratory Care 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

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. Fuller IMPRESS summary will follow soon.

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 commisisoning toolkits for GP commisioners.  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.

27 August 2010 - The British Lung Foundation, supported by the Department of Health, the National Institute for Health Research, Medical Research Council and the British Thoracic Society, is running a one-day workshop “Where Next in Asbestos Research: A Workshop” at the Wellcome Trust in London on 23 November 2010.
Click here for more information.

23 July 2010 - latest presentation on the National Strategy from Robert Winter available to view.

21 July 2010 - IMPRESS Guide to Information -  - to accompany the guide to medicines use information already available.  A practical guide for clinicians and commissioners about data and information related to respiratory care: what is there, why would you use it, where to find it, and pros and cons. It brings together sources from the NHS, commercial and voluntary sectors and across primary, secondary and community care. Click here.

16 July 2010 - set of web-based resources to support primary care implementation of the national strategy in England from PCRS-UK : the PCRS-UK Quick Reference Guide. 

15 July 2010 - Equity and Excellence: Liberating the NHS.  The new white paper on the NHS in England was released on 12 July.  Until details are available about the outcomes framework, the 150 quality standards, or other details that specifically affect the provision of respiratory care, IMPRESS will not add commentary to what is already available from other policy analysts.  However, the white paper and briefings  are all available here.

15 July 2010 IMPRESS recommends a number of discussion papers issued just before the white paper (see above). 

Two on health and social care integration: (more...)
NHS  Confederation PCT Network briefing in association with Directors of Adult Social Services:
Where next for health and social care integration?

Paper from Chris Ham on progress in health and social care integration, focusing on Birmingham, Torbay and Northumbria.
 

Reorganisation and QIPP
The triumph of hope over experience
: Lessons from the history of reorganisation from Nigel Edwards, NHS Confederation 

Dealing with the downturn: using the evidence - from Nigel Edwards, NHS Confederation, including a useful economic analysis about what is needed to release cash with services such as hospital at home.
(more...)

Emergency admissions (more...)
The Nuffield Trust has published a briefing:
Trends in emergency admissions in England 2004–2009: is greater efficiency breeding inefficiency?  Thirty-five per cent of all admissions in the NHS in England are classified as emergency admissions, costing approximately £11 billion a year.  This paper examines the 11.8% rise in emergency hospital admissions in England from 2004/05 to 2008/09 and tries to identify the possible explanations. 

Quality Standards
NICE has now published its first
quality standards  for stroke, dementia and venous thromboembolism (VTE) prevention.

15 July 2010 - European Federation of Allergy and Airway Diseases Patients Association (EFA)  has launched the EFA Book on Chronic Obstructive Pulmonary Disease in Europe.Sharing and Caring full of facts and figures and a call to action.

7 July 2010 - New publication from IMPRESS: 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. It is written as a companion guide to the IMPRESS guide to information due out by 15 July.

1 July 2010 - New publication from IMPRESS - More for Less.  Click here for more.

23 June 2010 Two complementary documents have been launched on GP commissioning.  Giving GPs budgets for commissioning: what needs to be done? A discussion paper  comes from 6 influential policy organisations: NHS Alliance, Nuffield Trust, Kings Fund, RCGP, NAPC, NHS Confederation  and Developing GP Commissioning - a new form of local clinically led and empowered commissioning from the NHS Alliance.  Go here for more information.

21 June 2010 The DH has issued a revised operating framework for the NHS in England for the remainder of 2010/11. It heralds more substantive changes to the Framework for 2011/12 where indicators  will be removed that have "little or no clinical relevance."   Go here for more.

18 June 2010
- new dates announced for autumn meetings on the Strategy for COPD in England Partnership Working to Implement the COPD Strategy at a Local Level.  Go here to find out more and register. 

14 June 2010 - Lung Improvement pilots in each region announced. Click here for more information.

11 June 2010 - advance warning that IMPRESS guides to using information and More for Less - Discussion paper to inform the implementation of respiratory strategies within the context of limited resources with many practical examples are due out shortly.  Subscribe to IMPRESS RSS feed to be alerted when they are ready.

11 June 2010 the widely reported McKinsey March report to the DH about Achieving World Class Productivity in the NHS 2009/10 – 2013/14: Detailing the Size of the Opportunity is now available as a ppt  set of over 120 slides with facts and figures and forecasts to download.

11 June 2010 New toolkit to help clinicians involved in lung cancer care to engage with their local commissioners and make the case for improvements in lung cancer services published by the UK Lung Cancer Coalition.  

8 June 2010 - First speech by new Secretary of State for Health, Andrew Lansley, with focus on patient safety - more information for patients, restatement of the "nothing about me without me" principle, and if a patient is readmitted within  30 days the hospital will not receive any additional payment for the additional treatment.

28 May 2010 - Living and dying with COPD - we are proud to announce that  "The development of an educational package for clinicians involved in end of life care issues in COPD" has been accepted for oral presentation at the European Respiratory Society meeting in Barcelona in September 2010.  Click here for more information about Living and Dying.  Note that following testing in Bristol and Crewe, and updates such as new GMC guidance that comes into effect on 1 July 2010 (see Jargon Buster End of Life entry), the pack is being revised and will be relaunched in the autumn.  Some copies of the existing materials are still available.

27 May 2010 - Pulmonary rehabilitation page and Personalising Care page updated.

27 May 2010 - Total Place entry in Jargon Buster

23 April 2010 - thought provoking slides on competition, integration, improvement and public sector spending from the Nuffield Trust Summit 2010. Click here for slides. 

12 April 2010 - Pilots announced for National Strategy in England.  Proformas submitted by 30 April; decision by 17 May for year-long pilots. See here for more information.

1 April 2010 A new online tool for effective patient and public engagement in health from Picker Institute Europe commissioned by the Department of Health in England. Click here.

31 March 2010  - White paper on future of care launched.  See here.  Our response to the Green Paper consultation highlighting good practice across health and social care interface and explaining some of the challenges in respiratory care.   Also useful: IMPRESS Social care and housing Jargon Buster.


24 March 2010 
New evidence on networks and communities of practice

IMPORTANT!
  23 February 2010 - Consultation on a Strategy for Services for Chronic Obstructive Pulmonary Disease (COPD) in England  launched with six week consultation period. Both BTS and PCRS-UK submitted responses on behalf of their members.   Slides from all events can be found here.

22 February 2010 - A smokefree future: a comprehensive tobacco control strategy for England - summary and useful table showing respiratory deaths attributable to smoking.

5 February 2010 - Consultation on Services for COPD in England and plans for implementation
The Department of Health, in partnership with the 10 SHAs in England and NHS Improvement and supported by BTS, PCRS-UK, BLF and AUK, is holding a series of regional events for healthcare professionals to hear more about the content of the Strategy and to feed back views. To find out more, and to reserve a place please look here.

3 February 2010 - Personalised care planning - new information

IMPORTANT!   2 February 2010 Your ideas and experience required
We are asking for your clinical help in producing ideas and examples of changes made in your locality that have made a difference. Click here for further details

19 January 2010 updates on national strategies including  DH England Strategy From Good to Great, and Operating Framework for England.

Good practice pages updated.


10 December 2009  Joint Respiratory National Clinical Directors appointed,  Lung Improvement Programme launched in England and calls for examples of good practice in asthma and COPD. More

8 December 2009: free spaces still available on the national training workshop for the Living and Dying programme February 4th and 5th 2010 in Manchester.  Click here for more information.   WAITING LIST NOW IN OPERATION (Jan 2010).

3 December - IMPRESS Award announced Displaying Innovation in Integrated Primary and Secondary Respiratory Care.  More

13 November 2009 IMPRESS responds to the Big Care Debate. The Green Paper Shaping the Future of Care Together sets out a vision for a new care and support system. IMPRESS responded to the consultation, with advice from DH Long Term Conditions Delivery Support Team.

23 October 2009 - update on procurement and do's and don'ts of procurement

October 2009 - updates on commissioning - World Class Commissioning adds competency 11: Ensuring efficiency and effectiveness of spend and competency 6 requires priortisation of investment in line with different financial scenarios

October 2009 - New pages added on networks and spirometry!

September 2009 - IMPRESS responds to the Health Select Committee Inquiry into Commissioning

11 Sept - see the SEESAW report,  Shifting the Balance of Healthcare to Local Settings from the King's Fund. Tony Davison, who attended, says clnicians should take note of its key messages. For further information see here.

11 Sept - 2 articles in the BMJ on the impact of Payment by results are highlighted in the Jargon Buster: see Jargon Buster "Tariff".

4 Sept - DH England has issued a short film capturing the range of perspectives from some of the 16 Integrated Care Pilots (ICP).  See www.youtube.com/wcccomms

 


 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.

To be kept informed of updates to this site, please subscribe to the RSS feed. Click on the RSS icon to the right of this message.
     
IMPRESS is grateful to  its corporate supporters - AstraZeneca, Boehringer Ingelheim/Pfizer and GlaxoSmithKline who provide grants for this independent programme of study
Home | Contact Us | Login