What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?

Children are still dying from asthma.

One of the biggest issues in effective management is effective diagnosis: if you are not diagnosed with asthma, you are unlikely to:
-Be called for review
-Have your medicines optimised
-Hold a personalised asthma action plan [which in itself reduces your risk of attack by 3/4]
-Effectively manage your own health and wellbeing

We know that quality diagnostics are difficult to reach, and to run, with such a high volume condition. When we consider this in the context of North-East London- one of the most deprived areas in the U.K, and certainly one of the most populated and diverse, access becomes a significant issue.

Furthermore, with the global pandemic, quality-assured spirometry is difficult to obtain. Many patients are travelling to the tertiary centre for lung function, incurring cost to their families, time out of education, cost and increased waiting times for the hospital.

What does your project aim to achieve?

-Quality-assured tests, with quality reporting, by an appropriately trained and accredited HCP
-Targeting the riskiest CYP in our patch for timely and accurate diagnosis
-Levelling up services to meet national and global standards for asthma
-Improving access to care by bringing it closer to home, and to the CYP’s local team(s)
-Improving the sustainability & eco-friendliness of asthma care by reducing unnecessary travel, medicines burden, optimising devices (including reduction of HFA and carbon emissions), increasing adherence and supporting self-management.
-Improving patient/family experience through streamlined patient pathways and a one-stop hub model
-Improving patient outcomes by virtue of their improved asthma control & self-management
-Freeing up the tertiary physiology service for the difficult/severe patients who require more intensive support, have higher complexity and require more niche testing.

-Challenging the barriers to integration of primary care staff to specialist teaching/education, protecting their learning time by ensuring release of staff to engage with the clinic.

How will the project be delivered?

The project aims to create a one-stop clinic, wherein a child/young person can have:
-A full initial assessment with an asthma specialist
-Quality assured diagnostic testing with an accredited HCP
-Asthma education

The clinic or “hub” would be run from an easily accessible, central, CYP friendly location.

The sessions would be staffed jointly by the asthma specialist with primary care clinician, attended by physiology from Barts & supported in some sessions by play and/or pharmacy technician to enhance the CYP experience.

How is your project going to share learning?

We plan to evaluate the aims above, but also share our learning in setting up such a service (via the updates), user experience and clinician experience.

We aim to upskill all clinicians, along with the CYP and their families.

We hope that by working collaboratively between the secondary care asthma team, tertiary physiology service and primary care teams around the population, we can share learning across all three spheres of care.

We hope that working collaboratively in this way, with tangible and visible results for the CYP/families will help foster engagement and joined-up working for the borough. Ultimately we hope that this work could be replicated across the whole network.

We hope that by starting in one location, in one borough we can demonstrate the merits of this model, and replicate/share across the network in time.