A Seamless Service.

     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

      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……

     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

      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

      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

    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

Patient admitted to AMU Assessed by team Daily review by team. Education, self management plans, rescue meds given & inhaler technique checked Medically fit for discharge Loan nebuliser issued (if needed ) Transferred to ward Referral to Community respiratory team faxed

Referral from : • • Single point of Care ‘Potteries Way’ • GP / Practice Nurse Referral from Acute or Community Hospitals • • Step down post exacerbation follow up Oxygen review Triage by Nurse Specialist Home visit Discussion with or review by Consultant Clinic Appointmen t Discharge to GP & / or Lead Health Professional with Action Plan Follow up at Acute Hospital for further investigation

   Dr Martin Allen: Secretary).

[email protected]

Tel Number 01782 675753 (Alison Jessop Karen Leech: [email protected]

Number 01782 674069 Tel Vicky Campbell: [email protected]

0300 1230995 ext 4538 Tel Number