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					PJS/09/31                                          28 May 2009


                      Managing COPD in the community




Care and rehabilitation of patients with chronic obstructive pulmonary disease
(COPD) in south east Essex are being improved by a unique participation
between Southend University Hospital, NHS South East Essex and practice-
based commissioning groups.
Community clinics will not only benefit patients by being more easily accessible
and avoiding possible admission to hospital, but will allow all staff involved in
their treatment to discuss any concerns with a visiting Southend University
Hospital consultant, without the patient necessarily attending the clinics.
Another innovation is that these same staff – hospital nurses, practice nurses,
community matrons, rapid response teams, etc - will have the opportunity to
increase their knowledge by completing a newly-introduced university course.
In collaboration with the University of Essex, the hospital and NHS South East
Essex have set up a certificate in respiratory medicine, as a module
contributing to a MSc. Consultant chest physician and Southend University
Hospital’s clinical director of acute medicine, Prof Tony Davison, who was
behind the innovation, has been appointed visiting professor and all his
respiratory consultant colleagues are also involved in the drive to upgrade
skills.
The module covers the causes of COPD, its effects, necessary investigations,
monitoring and rehabilitation.
Prof Davison, who chairs Improving and Integrating Respiratory Services in the
NHS (IMPRESS) – a joint initiative between the British Thoracic Society and
the General Practice Airways Group - said: “This is a unique venture, designed
to fulfil the Darzi vision of bringing care closer to the community. Our concept is
to make sure the necessary knowledge and skills are in place so the vision can
be put into practice. There is no point in moving care closer to patients’ homes
if there is not the expertise to deliver it. And, because we have established a
course with the University, it is sustainable – not just pump-primed and left to
vanish.
“Both NHS South East Essex and Southend University Hospital feel there is a
real opportunity to produce a marked improvement in patient care. The aim is
to increase the number of staff taking the course so that eventually everyone
involved in a patient’s care – whether in hospital or in the community – will
have completed it.
“Fewer patients will then get admitted and their care will be improved, along
with their quality of life.”
As part of the project, availability of pulmonary rehabilitation is being increased
in south east Essex. Until now, only patients already being treated in hospital
could access the scheme. This is now being expanded into primary care to
prevent patients having to be admitted for acute care.
COPD affects one in eight emergency hospital admissions each year,
accounting for more than one million bed days. But, says, Prof Davison, many
patients are unaware they have the disease which almost universally affects
current and ex-smokers.
“We hope to improve the number of people we diagnose so they can be
managed appropriately. The whole project will raise the standards of care for
all patients with COPD. A district-wide database is being set up which will
mean that care will be delivered where it is required. Inequality and wasteful
duplication of provision will be reduced.”
Robin Brook, service redesign and commissioning manager leading on COPD
for NHS South East Essex, said: “COPD is a top priority for the PCT. In moving
    this project forwards, we have significantly enhanced partnership working
    across all sectors.
    “There is growing interest and enthusiasm among our practice-based
    commissioning groups to develop innovative commissioning and service
    delivery proposals and NHS South East Essex believes this project will raise
    the standard of care for all patients with COPD.”
    Dr Robert Winter, OBE, medical director for NHS East of England, said: “This
    is an excellent example of clinical leadership and innovation – work which
    resonates strongly with the principles underpinning the NHS Next Stage
    Review in the East of England.
    “The integration between primary and secondary care brings the potential of
    providing high-quality specialised care closer to home. This more holistic
    approach is poised to improve the patient experience for people living with
    long-term conditions. By developing a programme of training right across
    primary and secondary care, Prof Davison and his colleagues are developing a
    truly integrated service for patients with lung disease.”


    ends




________________________________________________________________
For more information please contact Pat Stone on 01702 385048
Fax 01702 385953 Email pat.stone@southend.nhs.uk
Visit the new hospital website on www.southend.nhs.uk

				
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