Working Together as a Respiratory Community June Roberts

How will we.... Find our missing COPD millions? Support non specialists to make accurate diagnoses? Support prescribing practice in line with NICE /BTS guidelines? Ensure pulmonary rehabilitation is available for all our patients who need it - and encourage referrals.? Develop systems to minimise the risk of exacerbations , hospitalisations and LOS for our patients? Identify and support those with end stage disease? Ensure our local workforce to have the knowledge, skills and confidence to care for and support people with COPD? NOTES FOR PRESENTERS: These questions are suggestions that have been developed to help provide a prompt for a discussion at the end of your presentation – please edit and adapt these to suit your local situation. Additional questions: How does our service for patients needing non-invasive ventilation compare with the guideline recommendations?

Current State Desired State Driving Forces Resisting Forces Lewin, 1951 Force Field Analysis

Clinical Leadership Data collection and repository - 3D picture Stakeholder engagement – regional boards Prioritise work streams Identify and disseminate best practice

Service organisation One unit had no permanent Respiratory Physician 9/27 (30%) units never meet with PCT 5/27 (19%) meet on PRN basis Others meet between 1-12 times per year Six units have no clinical Oxygen lead

Stakeholder Mapping

Local data and clinical acumen

Change = 0pportunity We do some things well We do some things badly We would like to do more

Final Thoughts............. Use local data to stimulate discussion Communication and engagement Learn from others Set standards Work with commissioners and providers to improve quality and release productivity savings