1. GRASP-COPD Hannah Wall, Programme Delivery Manager hannah.wall@nhsiq.nhs.ukhannah.wall@nhsiq.nhs.uk 07920845437

2. What is GRASP? GRASP was originally created for stroke prevention in Atrial Fibrillation as a practice risk stratification/ case finder tool (GRASP-AF) Initially developed by the West Yorkshire Cardiovascular Network, the Leeds Arrhythmia team and PRIMIS, as part of the NHS Improvement AF in primary care national priority

3. How GRASP-AF works MIQUEST queries to identify patients with a diagnosis of AF Stroke risk calculated using CHADS 2 Highlights patients with a CHADS 2 score of 2 or more not receiving warfarin who would benefit from review to assess anti-coagulation need Does not assess contraindications to warfarin, the decision whether or not to start warfarin remains a clinical one

4. Snapshot of the tool - dashboard

5. Snapshot of the tool – dataset

6. Evolution of GRASP-AF GRASP-AF is now in use in more than 2600 practices in England It’s estimated that 170 strokes have been prevented as a result of using this tool GRASP-AF is still available and is free to download In 2012 the success of GRASP prompted the creation of two new stratification tools – GRASP- HF (heart failure) and GRASP-COPD

7. Why GRASP for COPD? 1 person dies from COPD every 20 minutes 1 in 8 people over 35 has COPD that has not been properly identified or diagnosed, and over 15% are only diagnosed when they present to hospital as an emergency COPD is the second most common cause of emergency admissions to hospital Over 50% of people currently diagnosed with COPD are under 65 years of age

8. Key priorities for primary care Public awareness - undiagnosed Prevention – lung health Smoking cessation Early/accurate/differential diagnosis Quality assured spirometry Disease registers and risk stratification Medicines optimisation and self-management

9. GRASP can help with these: Public awareness - undiagnosed Prevention – lung health Smoking cessation Early/accurate/differential diagnosis Quality assured spirometry Disease registers and risk stratification Medicines optimisation and self-management

10. Audit 1 Patients diagnosed with COPD The results will enable you to: –Audit your management of patients with COPD against current NICE guidance –Identify patients who may be inaccurately diagnosed and therefore not being treated according to the NICE guidance –Review patients who have a diagnosis of both asthma and COPD –Easily assess and visualise clinical data about your patients with COPD

11. GRASP-COPD dashboard Current diagnosed pop and no who are smokers Diagnosed by FEV and treatment regime Management plan

12. Audit 2 Patients not yet diagnosed with COPD The results will enable you to: –Identify patients potentially missing a COPD diagnosis code –Identifying patients at risk of developing COPD –Providing several pre-set filters to prioritise those patients most likely to need a review

13. GRASP-COPD case finder

15. GRASP-COPD - datasheet

16. GRASP-COPD – the benefits Free to download and use Easy to interpret Uploading anonymous data back to PRIMIS gives access to benchmarking data for CCGs at local regional and national level Provides a case finder and a ready-made disease register with the ability to select/ examine different patient groups

17. Who is using GRASP-COPD? No of practicesAF%COPD% East of England SCN NHS Luton CCG3129 93.55%00.0% NHS West Suffolk CCG2516 64.00%00.0% NHS Mid Essex CCG5022 44.00%00.0% NHS Great Yarmouth And Waveney CCG2710 37.04%00.0% NHS Herts Valleys CCG7013 18.57%00.0% NHS North East Essex CCG457 15.56%00.0% NHS Bedfordshire CCG557 12.73%00.0% NHS Castle Point And Rochford CCG283 10.71%00.0% NHS West Norfolk CCG232 8.70%00.0% NHS South Norfolk CCG252 8.00%14.00% NHS Ipswich And East Suffolk CCG423 7.14%00.0% NHS Cambridgeshire And Peterborough CCG1077 6.54%00.0% NHS Norwich CCG241 4.17% 2 8.33% NHS Basildon And Brentwood CCG450 0.00%00.0% NHS East And North Hertfordshire CCG590 0.00%00.0% NHS North Norfolk CCG200 0.00%00.0% NHS Southend CCG360 0.00%00.0% NHS Thurrock CCG340 0.00%00.0% NHS West Essex CCG390 0.00%00.0%

18. How to get GRASP-COPD Visit PRIMIS and sign up to the Hub Follow download guidance for relevant practice system Various documents available to assist with running audits and interpretation and analysis of results Guidance also available on uploading Technical support on installation available through NHS Improving Quality

19. Thank you. QUESTIONS