A Seamless Service.

 Recognition that COPD and asthma a significant problem for our health economy  Data: 1800 admissions in 1996  1995: COPD and asthma GL  Across economy, DPH’s involved  Revised 1998 after first BTS GL  COPD education project  1998 – pathway working

 1997: open access spirometry with report  2000: Hosted BTS early discharge course  2001 SED: 1200 reviewed, 300 at home  Activity across hospital, LOS 9 to 3 days  : SAM. Economy sign off  4 then 2 PCTs, now 2 CCGs  Different speeds of development  2008 – community services  UHNS, commissioners, provider units  Clinics, PR, nebuliser……

 SED still functions to identify patients for community service integration  SED reviews patients for oxygen prior to discharge  Education & Self Management as an inpatient.  Tier 4 oxygen clinics  T4 COPD clinics

 NIV since early 1990’s  Takes place on a bespoke 12 bedded respiratory HDU  Nurse led initiation and setting change  24/7 consultant support  Go beyond boundaries (pH of 7)  10% mortality

 Quality assured spirometry  Supported in practices by community physiologist  UHNS outreach  PR a success with low drop outs  T3 oxygen service  Specific community nursing team  COPD focused, do SED follow ups / step-up  x6 consultant community clinics per week  x1 consultant MDT per week

 1200 places offered across North Staffordshire per year  8 venues across the locality – 2 sessions per week for 8 weeks  High level of satisfaction from questionnaires  Multi-disciplinary team input and signposting to wider community services

Patient admitted to AMU Assessed by team Transferred to ward Daily review by team. Education, self management plans, rescue meds given & inhaler technique checked Medically fit for discharge Referral to Community respiratory team faxed Loan nebuliser issued (if needed )

Referral from : Single point of Care ‘Potteries Way’ GP / Practice Nurse Triage by Nurse Specialist Home visit Clinic Appointmen t Discussion with or review by Consultant Discharge to GP & / or Lead Health Professional with Action Plan Referral from Acute or Community Hospitals Step down post exacerbation follow up Oxygen review Follow up at Acute Hospital for further investigation

 Dr Martin Allen: Tel Number (Alison Jessop  Karen Leech: Tel Number  Vicky Campbell: Tel Number ext 4538