1. A Seamless Service.

2.  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  1996-8 COPD education project  1998 – pathway working

3.  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  2006-8: 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……

4.  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

5.  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

6.  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

7.  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

8. 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 )

9. 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

10.  Dr Martin Allen: Martin.Allen@uhns.nhs.uk Tel Number 01782 675753 (Alison Jessop Secretary).Martin.Allen@uhns.nhs.uk  Karen Leech: karen.leech@uhns.nhs.uk Tel Number 01782 674069karen.leech@uhns.nhs.uk  Vicky Campbell: Victoria.Campbell@ssotp.nhs.uk Tel Number 0300 1230995 ext 4538 Victoria.Campbell@ssotp.nhs.uk