July 2012
North West Respiratory Clinical Pathway Team - winners from the 2012 awards, offering examples of good practice
Download the full report or see below for summaries
Stop smoking - NHS Blackpool
Benefits:
Regardless of the spirometry result, whether normal or abnormal, a clear understanding of your lung health appeared to be a powerful motivational trigger and teachable moment for behaviour change. This innovative model potentially provides all the ingredients in one location for promoting smoking cessation as described by Robert West in the 3 Ts strategy: Tension, Trigger, Treatment. The offer of a lung health check was exceptionally popular in all settings, even among traditionally hard-to-reach groups, and could be targeted according to local need. Joint working with the smoking cessation service improved the outcome for smokers as it took advantage of the immediate situation, triggering the impulse to make a quit attempt. Blackpool has one of the highest smoking prevalence rates in England. Smoking related diseases account for half the health inequalities. Smoking is entrenched in routine and manual groups to the point where it is completely the cultural norm. Encouraging smokers to attend evidence based smoking cessation services is hugely cost effective in the long run. Identifying smokers with pre- or undiagnosed COPD and encouraging them to quit will improve outcomes and generate savings from reduced hospital admissions.
Quick wins:
Lung health checks are very popular with the public, employees, NHS staff and older people. Extensive marketing of an event is not necessary. We have been astonished at the demand for lung health checks. Capitalising on this by integrating the much less popular carbon monoxide testing into the offer reaches out to people who do not traditionally access health services.
COPD Case Finding - Sandfield Medical Centre
Benefit for the health economy:
Since engaging in the project, we have doubled the prevalence of COPD in our practice, and understandably we now prescribe more respiratory medications. However, surprisingly we have also reduced overall respiratory prescribing costs. This is achieved by more appropriate prescribing and better patient education.
Quick win:
We would recommend that every practice starts doing something like this engaging in a holistic culture change focusing not only on early detection but also enhanced management. The easiest 'quick win' would probably be finding your most at risk patients. NICE recommends screening anyone >35 with a smoking history, though obviously this can be stratified easily into different levels of risk. Do a quick search on patients >65 who are current heavy smokers, or look at patients diagnosed with 'adult onset' asthma - many of these will turn out to be COPD. If you set the searches for the high risk group properly you will easily find that at least one in three have COPD.
IMPRESS awards
June 2011
Two of the IMPRESS Award winners focused on COPD and the third on the use of NIV for people with motor-neurone disease.
Category II Increasing high value services and reducing low value services
Winner: Increasing the value of COPD care in Islington using a Local Enhanced Service (LES) to improve COPD case finding and management M Calogne-Contreras, J Billett, L Restrick, KL Sennett, C Cooper, W Carswell, S Dougan, M Stern
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Ccopies of all three years of the LES are available here in Publications - other
Category III. Integration across boundaries
COPD Rescue Packs: Why you should make them and how to do it. Jennifer M. Stevenson, Dr Noel Baxter, Dr Craig Davidson, Karen Newell, Jacqui Fenton, Christabelle Chen, Tracey Fleming, Dr Barry Gray, Professor John Moxham
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Health and Social Care Awards 2011
March 2011
The COPD service provided by Southend University Hospital, NHS South East Essex, practice-based commissioning groups, Breathe Easy, University of Essex and East of England Ambulance Service was highly commended in the Health and Social Care Awards, East of England in 2010. To read the team's submission go here. For their new commissioning case for a community respiratory service, go here.
January 2010
NHS Evidence examples of changes to increase quality and productivity see here.
IMPRESS Awards
December 2009
Both the award winner of 2009 IMPRESS Awards Displaying Innovation in Integrated Primary and Secondary Respiratory Care and the Special Commendation focused on COPD care pathways.
The 2009 IMPRESS Award was presented at the 2009 BTS Winter Meeting:
2009 Award Winners
COPD Patient Pathway Project
Guy’s and St Thomas’ & Kings Charities
Guy’s and St Thomas’ and Kings College NHS Foundation Trusts
Lambeth & Southwark Primary Care Trusts
2009 Special Commendation
The South East Essex Model for Integrated COPD Care
Southend University Hospital
South East Essex PCT
Audley Mills Surgery
School of Health and Human Sciences, University of Essex
Southend Breathe Easy
July 2009
The IMPRESS Award 2009 Special COmmendation, NHS South East Essex, with their practice-based commissioners, were also commended by NHS East of England Medical Director for their clinicially-led commissioning of improved COPD care. The service includes:
June 2009
The winners of GP Magazine Innovative Clinical Care Enterprise Award are Drs Robin Carr and Richard More, of Avanaula for their community COPD services in Somerset. Click for a summary in GP Magazine. Dr Carr told IMPRESS "If there is a lesson that we have observed through this journey it is that COPD is an illness that requires the coordination and cooperation of all healthcare personnel each fulfilling their individual roles. There are many opportunities for patients to “drop through the cracks” and managing the interfaces and communication is essential."
2008
The 2008 IMPRESS Award
The 2008 IMPRESS Award was presented at the 2008 BTS Winter Meeting:
2008 Award Winners
Salford’s Integrated COPD Service
Salford PCT
Salford Royal Foundation Trust
2008 Special Commendation
Patient Focused Integrated Respiratory Care
Solihull Care Trust
Solihull Hospital, Heart of England Acute Trust
The winner of the British Thoracic Society Silver Jubilee Award* (Dec 2007) for innovation in the delivery of care closer to the patient was the COPD Services, Nottinghamshire County Teaching PCT and Sherwood Forest Hospitals NHS Trust.
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Special commendation: Ashford & St. Peter's Hospitals NHS Trust and Surrey PCT North West Locality
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* The Silver Jubilee awards celebrate the excellent teamwork which is at the heart of high quality service delivery as well as the commitment to the highest standards of respiratory healthcare in seven categories. For a full list see the British Thoracic Society web page here.
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