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What is the challenge your project is going to address and how does it connect to your chosen theme?

Evidence shows that Respiratory disease affects one in five people and is the third biggest cause of death in England. Hospital admissions for lung disease have risen over the past seven years at three times the rate of all admissions generally. Respiratory diseases are a major factor in winter pressures faced by the NHS and most respiratory admissions are non-elective and during the winter period these double in number.

We have identified a number of causes for this situation. These include a lack of awareness of the disease:-

·         A lack of empowerment to deal with their own condition.

·         Challenges in obtaining appointments and care at GP surgery.

·         Continued exposure to smoke and other sensitising environmental factors. (This may also include poor living conditions).

·         Incorrect and or inappropriate use of inhalers, antibiotics, and other medication.

·         Incorrect or no diagnosis of the conditions.

What does your project aim to achieve?

Through a more collaborative system that puts the patient at the centre and empowers them to understand their own condition, we believe that we can improve their quality of life, and at the same time reduce pressure on outpatients, A&E and GP appointments.

We are all aware that having the patient set their own goals is critical to enabling change and supporting better outcomes. Patients visit a community pharmacy to collect their prescription and frequently this healthcare team sees these patients most often. We will use pharmacists to work with patients and set/define their goals. This will be shared with the practice (if not done already) and together the teams will support patients to reach these goals through better health choices and interventions eg:

·         Better use of inhalers, vaccination, & PR uptake

Critically the improved outcome would be the “patients goals met”. The health benefits reached would be measured through reduced use of health resources eg, GP time & A&E

How will the project be delivered?

There are lots of different projects that promote collaboration. In this project we are going to work with the Institute for Collaborative Working to understand how the principles of collaborative working as applied in business relationships may be utilised for multi disciplinary relationships and patients. We will use the process developed for the International Standard (ISO44001) to guide the project. This will include understanding the attitudes and behaviours of the partners that fuel the current challenges. For example the challenges in sharing of patient data, access and availability of healthcare teams, contractual financial incentives and penalties   We will establish a Collaborative  working group to include the CCG, GPs, Community Pharmacy, patients and advised by ICW.

What and how is your project going to share learning throughout?

We will share our learnings and outcomes as early and widely as possible through different organisations including CCG and wider health professionals in Manchester.   need to start with building a collaborative relationship between the community pharmacy and the GP practice with the patient at the centre of that relationship. We start by engaging with the patient to understand their experience of living with the long term condition and the outcome that they would wish to achieve. We need to understand the barriers that they currently face.

Comments

  1. Dear Adam

    The pharmacy centred approach here sounds really valuable; very much an underused resource.

    Have you thought about how you might address that under-use, potentially releasing pharmacist time to deliver the patient supporting measures you outline?

    As Anna says, we have a proposal for outpatient service innovation in Gloucestershire which is using a co-design approach - this could be really valuable for your approach to ensure it maximises the chance for patient engagement once you are up and running.

    Charlie Sharp

    Gloucestershire

  2. Dear Adam,

    have you seen that there is a respiratory outpatient idea on the QExchange from Gloucestershire? I wonder if there is any mileage in connecting?

    best wishes

    Anna

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