1. Respiratory Service Framework Asthma and COPD Care (Nursing) Project Learning and Development Strategy

2. What is a Service Framework?  Explicit standards on prevention, treatment and care  “Quality requirements” supporting the standards  Specific timeframe - 3-5 years and revision process  Capable of measurement/comparative data  Linked to the HSC quality standards and other policy, documents and guidance  Applicable to both adults and children  Follow a life cycle approach  Developed in collaboration with the HSC and public.

3. Patient/ client Pathway Template Prevention / Promotion Protection /Lifestyle Assessment & Diagnosis Treatment Ongoing Care / Chronic Disease Management End of Life Care / Palliative Care

4. Overarching Standard 6.1.4 Long term oxygen therapy All patients with COPD, who are hypoxic (low oxygen), should have referral for assessment and prescription for long-term oxygen therapy if appropriate. Rationale Long oxygen therapy (LTOT) improves survival and reduces hospital admissions in patients with COPD who are hypoxic. Evidence  National Institute for Clinical Excellence (2004) Management of chronic obstructive pulmonary disease in adults in primary and secondary care. National Institute of Clinical Excellence: London http://thorax.bmj.com/content/vol59/suppl_1/  Royal College of Physicians Domiciliary Oxygen Therapy Clinical guidelines 1999 http://www.rcplondon.ac.uk/pubs/brochure.aspx?e=78  British Thoracic Society. Clinical component for the home oxygen service in England and Wales January 2006. Available from http://www.brit- thoracic.org.uk/c2/uploads/clinical%20adultoxygenjan06.pdf.http://www.brit- thoracic.org.uk/c2/uploads/clinical%20adultoxygenjan06.pdf Responsibility for delivery / implementation HSC Trusts Primary Care Community specialist respiratory team Quality Dimension Patients being considered for LTOT and/ or ambulatory oxygen should be assessed according to NICE Guidelines. Performance IndicatorData SourceExpected Performance LevelDate to be achieved by Percentage of patients who meet the NICE criteria, who have LTOT and/or ambulatory oxygen prescribed. DES dataset Trust database 85% 90% 95% March 2010 March 2011 March 2012

5. Occasionally to commonly Occasionally to commonly treat people treat people with respiratory nursing care needs Tier 1 Commonly to frequently treat Commonly to frequently treat people with respiratory nursing care needs Tier 2 Dedicated practitioner Dedicated practitioner Tier 3 Asthma and COPD

6. Need to do better? COPD Need to do better? Asthma Not do at all? COPD Not do at all? Asthma Tier 1 Tier 2 Tier 3

7. Themes from the workshop Clinical Skills and Knowledge Overview of disease process and management Assessment and monitoring Communication skills Teaching skills Knowledge of menu of services Pulmonary Function tests Nebulisers Smoking cessation and Prevention Oxygen therapy Pulse Oximetry NIV PEFR Pulmonary rehabilitation Inhalers Clinical skills and knowledge Audit/ information management/ research/ performance management Leadership Networking/ cross speciality liaison/ sharing Self management/ patient education Training, non-specific

8. Presentations This presentation will be available for download at http://www.nipec.n-i.nhs.uk/presentations