Sorry for the rather long gap between blogs - it's not for lack of behind the scenes activity.

From the user's perspective, IMPRESS resources continue to meet a need for many clinicians and commissioners.  There have been 45,500 downloads in the last year!

Breathlessness

Meanwhile, IMPRESS has been working with colleagues from the London School of Economics, primary and secondary care cardiology, the RCP Action on Obesity and behaviour change experts to develop guidance for commissioners, providers and patients on the detection and management of breathlessness and what breathlessness services might look like.  This work extends our thinking on value by considering how best to address the challenges of multi-morbidity starting with a particular and common symptom such as disabling and long-term breathlessness.  We are in the process of producing BITs: Breathlessness IMPRESS Tips, that will be fully referenced and cover prevention, diagnosis, management at an individual and population level.  It's not easy work, as it brings together opinion and evidence from different fields such as COPD, asthma, obesity, dysfunctional breathing and heart failure and different patient and professional perspectives, but it is very illuminating, and we hope to debate our BITs with you over the coming months.  If you want to get involved please contact Siân Williams at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Our plan is to launch our BITs for clinicians, commissioners, patients and researchers by mid-November to coincide with World COPD day, but there are opportunities to get involved in commenting before that.

Integration

Meanwhile, keep an eye on the tweets, which bring you the latest news about research, policy or other news.    You'll have seen the National Voices narrative about integration, which is a great starting point for local discussions:

National Voices: Integrated care: what do patients, service users and carers want?

People want co-ordination. Not necessarily (organisational) integration.
People want care. Where it comes from is secondary.

There are also some interesting developments in patient-held records, that support care integration: have a look at Patients Know Best: the patient/carer holds an electronic web-based record and they decide which healthcare professional they permit to access it. It can also be used for electronic communication, and is showing gains in time for patients and healthcare professionals.  BMJ 2012;345:e5575

There is also a regional rollout of electronic end of life registers - some of these are including templates for COPD advance care planning.  Does anyone have the full list of how to access these?

Regional resources

We're also going to load onto the website resources from the regional teams.   Whilst this is work in progress, have a look at two of the regional teams' material:

 The London Respiratory Team's webcasts on value  here

East Midlands Respiratory Network here