1. South Essex COPD Psychology Project- Improving psychological well-being in patients with COPD

2. Introduction It is well recognised that patients with COPD are at risk of anxiety and depression 2012 – set up a severe disease MDT Established that many patients had psychological needs that were not addressed January 2013 – secured funding for a one year pilot The Southend COPD Psychology service

3. Screening Screening tools COPD care bundle Training Community and Pulmonary rehabilitation assessment Psychology champions

4. Our model of psychological support Tier 1: Individual Sessions (up to 12 sessions) Tier 2: Group therapies tailored to COPD (6-8 sessions) ACT/CBT Tier 3: Pulmonary rehab & CBT CBT PR prep course Tier 4: Self help/Guided self help tailored to COPD All available on both an inpatient, outpatient and home basis.

5. The Interventions Direct Interventions – 1:1 evidence based therapy with specialist Clinical Psychologist (up to 12 sessions) – CBT group (6 sessions) – Acceptance and Commitment Therapy Group (8 sessions) – Assessment only – Inpatient sessions Indirect Interventions – Consultation with MDT – Guided self help delivered by Nursing staff in community and hospital (4 sessions) – Psychological input and joint work in Hospital Pulmonary Rehab program. – Basic psychological Self help – Training in CBT and motivational interviewing – Supervised practice

7. Clinical Outcomes – follow up

8. Financial Outcomes Inpatient AdmissionsA&E attendance Total savings467 208 Cost of service120 000 Total 12 month saving347 208 Mid-treatment as analysis point

9. Summary Truly multi-disciplinary approach which has identified and addressed psychological needs in patients with COPD Embedded psychological care of patients with COPD across the whole care pathway Statistically robust clinical, financial and patient satisfaction outcomes Developing the skills of the wider MDT has increased the confidence of the team in dealing with these issues