1. Be Inspired – a non pharmacological breathlessness management pathway Sue Acreman April 2010

2. The 8 domains of care Physical Practical Nutritional Psychological Informational Spiritual Financial Social

3. Background Evidence review 2008 Service provision survey Audit Local demographics/ stats

4. Aims Develop a sound, evidence based pathway Equity of access to care Empowerment and independence Widen knowledge and skills in managing breathlessness

5. Resources/outputs Pathway Assessment measures Handbook Calming hand Systematic focussing Relaxation technique Education programme

6. Step 1:Triage - Meets criteria EXIT pathway - No Yes Step 2: Refer for BeInspired Intervention Yes No Step 6: Initiate referral for complex case management -Goal setting -Outcome measures -Self management plan Step 5: Review Are BeInspired interventions adequate for patients needs? Step 4: Assessment and Intervention – still meets criteria Iniatiate Supported self management -Triggers -Beinspired handbook -Signpost Step 3: Arrange Appointment send self assessment form & daily activity impact diary

7. Results – 1 (February 2010)

8. Interim Results – 2 (February 2010)

9. Interim Results – 3 (February 2010) Type of Intervention 83% 17% Complex case management Self management

10. Interim results (4) It is nice to have all the necessary information in one place to hand If only I had known all this before All useful-good simple basic details that have helped my breathing I couldn’t believe I had been struggling so long with my breathing and the answer was so simple once explained

11. Conclusions Dyspnoea is not routinely assessed and is an expected burden for many people with cancer Dyspnoea can affect all patients with cancer, irrespective of tumour site Early evaluation suggests that appropriate patients are being identified and the pathway and other resources are fit for purpose

12. Contact details sue.acreman@wales.nhs.uk Work mobile: 07837163930