Improving care for patients with COPD
Patients and healthcare professionals are working together to ensure consistency of primary and secondary care for patients with respiratory diseases.
Leader: Liz Boal, Service Improvement Lead
Lead organisation: Derwentside PCT
SHA: NHS North East
Duration: July 2004 - Jan 2006
Project objectives
An estimated 900,000 people in the UK have Chronic Obstructive Pulmonary Disease (COPD), a long-term illness that narrows lung tissue and prevents air flowing freely through the lungs. Sufferers account for 100,000 hospital admissions across the UK – one in eight of all emergency hospital admissions.
The problem was particularly pressing in North Durham where there is a high incidence of COPD, resulting in greater numbers of emergency and repeat hospital admissions. Combined with the lack of a dedicated rehabilitation services in North Durham, there was a feeling that COPD suffers weren’t getting equal access to care.
How it works
Derwentside PCT and Durham and Chester-le-Street PCT came together with County Durham and Darlington Acute Hospitals NHS Trust to tackle the problem.
Starting in July 2004, a steering committee was established to work with patients and carers. The aim was to map the existing services for patients with respiratory diseases and then devise action plans to redesign a better, more seamless care pathway. Still under development, the new pathway aims to provide a ‘clear route of care’. In other words, it should help staff in primary and secondary care to work together more effectively to ensure consistently high standards of care and support for patients.
Patient involvement has come through the local Breathe Easy Group, a support group for patients with respiratory problems. Two COPD patients have actually joined the project team, which also consists of a range of primary and secondary care healthcare professionals including GPs, practice nurses, physiotherapists, secondary care consultants, members of the ARAS team, clinicians and managers drawn from the two sponsoring PCTs and the acute hospitals.
Shared learning and challenges
Liz Boal, the project leader, is modest about the achievements of the project so far: “It is not rocket science – many of the changes are straightforward improvements which will help create a more patient focused care pathway.”
She points out that in some ways, the real challenge is to maintain the momentum of the project when so many of the team members have highly demanding and pressurised jobs.
Liz’s two solutions are NHS Live, which she sees an important way of injecting new energy into the project, and staying focused on the project’s original vision – improving life for COPD patients.
Allied to the practical improvements there is an initiative to give better quality and more consistent information to patients about their condition. This need emerged from the mapping sessions which suggested that there was a lack of consistency in primary and secondary care.
On a wider scale, Liz is confident: “Rehabilitation has come to the fore,” she says. “Research has shown conclusively that rehabilitation greatly improves the health and well-being of patients.” The project team is keen to make this new service as accessible as possible and is already investigating the possibility of a home-based service for housebound patients.
Outcomes and future plans
The most important change has been a new rehabilitation programme for COPD patients, based at a local hospital. Introduced in August 2005, patients now receive a two-hour session with a physiotherapist twice a week for up to ten weeks. The goal of the programme is to help patients increase their tolerance of physical exercise and thereby their independence and quality of life.
Alongside this is a new smoking cessation service available to patients whilst in hospital. Ward staff are being trained to help deliver the service and Nicotine Replacement Therapy (NRT) is now available immediately without the patient having to visit their GP. Spirometre training is also being developed for primary care workers, which should improve patient assessments.Finally, the project team is looking at how district nursing staff can offer more support to COPD patients as part of the overnight district nursing service. “People often panic when they have breathing difficulties in the night, increasing the likelihood of them being admitted to hospital,” says Liz. “If we can give patients more support and reassurance, they might be able to stay in their own homes - which will reduce the number of emergency admissions.”
The project is due to finish in January 2006. Part of the review process will be an assessment of its effect based on patient quality of life surveys; the number of A&E attendances; the number of admissions avoided; the length of stay; and a staff survey on the use of the pathway.
Key contacts
Liz Boal, Service Improvement Lead
Derwentside PCT
01207 594447
elizabeth.boal@derwentsidepct.nhs.uk
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Project objectives
An estimated 900,000 people in the UK have Chronic Obstructive Pulmonary Disease (COPD), a long-term illness that narrows lung tissue and prevents air flowing freely through the lungs. Sufferers account for 100,000 hospital admissions across the UK – one in eight of all emergency hospital admissions.
The problem was particularly pressing in North Durham where there is a high incidence of COPD, resulting in greater numbers of emergency and repeat hospital admissions. Combined with the lack of a dedicated rehabilitation services in North Durham, there was a feeling that COPD suffers weren’t getting equal access to care.
How it works
Derwentside PCT and Durham and Chester-le-Street PCT came together with County Durham and Darlington Acute Hospitals NHS Trust to tackle the problem.
Starting in July 2004, a steering committee was established to work with patients and carers. The aim was to map the existing services for patients with respiratory diseases and then devise action plans to redesign a better, more seamless care pathway. Still under development, the new pathway aims to provide a ‘clear route of care’. In other words, it should help staff in primary and secondary care to work together more effectively to ensure consistently high standards of care and support for patients.
Patient involvement has come through the local Breathe Easy Group, a support group for patients with respiratory problems. Two COPD patients have actually joined the project team, which also consists of a range of primary and secondary care healthcare professionals including GPs, practice nurses, physiotherapists, secondary care consultants, members of the ARAS team, clinicians and managers drawn from the two sponsoring PCTs and the acute hospitals.
Shared learning and challenges
Liz Boal, the project leader, is modest about the achievements of the project so far: “It is not rocket science – many of the changes are straightforward improvements which will help create a more patient focused care pathway.”
She points out that in some ways, the real challenge is to maintain the momentum of the project when so many of the team members have highly demanding and pressurised jobs.
Liz’s two solutions are NHS Live, which she sees an important way of injecting new energy into the project, and staying focused on the project’s original vision – improving life for COPD patients.
Allied to the practical improvements there is an initiative to give better quality and more consistent information to patients about their condition. This need emerged from the mapping sessions which suggested that there was a lack of consistency in primary and secondary care.
On a wider scale, Liz is confident: “Rehabilitation has come to the fore,” she says. “Research has shown conclusively that rehabilitation greatly improves the health and well-being of patients.” The project team is keen to make this new service as accessible as possible and is already investigating the possibility of a home-based service for housebound patients.
Outcomes and future plans
The most important change has been a new rehabilitation programme for COPD patients, based at a local hospital. Introduced in August 2005, patients now receive a two-hour session with a physiotherapist twice a week for up to ten weeks. The goal of the programme is to help patients increase their tolerance of physical exercise and thereby their independence and quality of life.
Alongside this is a new smoking cessation service available to patients whilst in hospital. Ward staff are being trained to help deliver the service and Nicotine Replacement Therapy (NRT) is now available immediately without the patient having to visit their GP. Spirometre training is also being developed for primary care workers, which should improve patient assessments.
Finally, the project team is looking at how district nursing staff can offer more support to COPD patients as part of the overnight district nursing service. “People often panic when they have breathing difficulties in the night, increasing the likelihood of them being admitted to hospital,” says Liz. “If we can give patients more support and reassurance, they might be able to stay in their own homes - which will reduce the number of emergency admissions.”
The project is due to finish in January 2006. Part of the review process will be an assessment of its effect based on patient quality of life surveys; the number of A&E attendances; the number of admissions avoided; the length of stay; and a staff survey on the use of the pathway.
Key contacts
Liz Boal, Service Improvement Lead
Derwentside PCT
01207 594447
