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End of the “better breathing for life”
COPD Project in
Lambeth and Southwark on March 31st 2011
The “better breathing for life” COPD project
ended on March 31st 2011. A new integrated
respiratory service has been proposed by NHS
Lambeth and Southwark and the outcome of
contract negotiations are awaited. We expect
many of the improvements in COPD care will
continue in the interim. The COPD project,
predominantly funded by Guy’s and St Thomas’
charity aimed to improve healthcare delivery
in COPD for Lambeth & Southwark residents.
Most of the objectives were achieved.
Pulmonary rehabilitation access and uptake
increased, STAR clinics, that provided a
multi-disciplinary one stop service in the
community, were established and a
considerable amount of patient, carer and
community education, backed by written
information, was provided. We established a
web accessible sector wide COPD database,
increased the detection of people with
significant COPD symptoms earlier in the
disease process and increased the support
for people at risk of repeated admission to
hospital with a 24/7 telephone support line.
The service was well received as a resource
for primary care as well as a lever in
improving integration with the hospital
services. Our success was recognised with a
national service innovation award from the
British Thoracic and Primary Care
Respiratory Society (Impress) in 2009.
The project did not reduce admissions for
acute exacerbations of COPD. Further
evaluation of the project continues but the
failure to have an effect in this area was
an unexpected and disappointing outcome and
indicates how difficult it is to do. Our
project and evaluating team are not alone in
highlighting the complexity of this issue.
The Kings Fund are also looking at what
interventions or changes will be required to
show repeatable effect in this area. We will
continue to work towards the goal of
providing the right care for people in the
right place at the right time.
Please note the following arrangements
for your patients with COPD until the new
service is in place:
1. Patients with COPD who need a specialist
review
Please refer to Chest Clinic at KCH or GSTT
2. Patients with COPD requiring Pulmonary
rehabilitation
Please continue to use the PR referral form
(PDF or Word) forms:
Pulmonary Rehabilitation Referral Form (pdf)
Pulmonary Rehabilitation Referral Form (doc)
3. Patients previously seen by the COPD
Project team at risk of exacerbation who
have been given access to 24/7 Action Line
These patients have received a letter
advising them that the 24/7 service is no
longer available. There will be a daytime
number for them to call at KCH and GSTT in
the interim.
At GSTT, the Outreach service that supports
patients after discharge will continue.
Patients on the service will be supported by
phone and by home visits for up to 2 weeks
after discharge.
4. Patients requiring lung function testing
Direct access lung function is available at
KCH. A referral to Chest Clinic will be
required for patients who want to be seen at
Guys or St Thomas’.
The Future
The new service will include Chronic Asthma
as well as COPD and have Pulmonary
Rehabilitation at its core. It will include:
• Finding and correctly diagnosing COPD and
adult asthma earlier
• Strong links with Stop Smoking Services,
Social Care and Community Pharmacy
• Supporting the primary care workforce to
improve skills and knowledge in COPD
• Prevention of hospital admissions and
re-admissions
• Intervening earlier when patients with
COPD start to exacerbate.
• Home Oxygen Assessment and Review service
We have enjoyed working with colleagues in
Lambeth and Southwark over the past 3 years
and look forward to a different way of
supporting you and your COPD and adult
asthma patients. We will keep you informed
of how the new service is developing.
Craig Davidson, Clinical Lead, GSTT
Noel Baxter, GP Lead
Jacqui Fenton, Nurse lead KCH
Barry Gray, Lead consultant KCH
Lauren Hogg PR Lead
Patrick White, Evaluation lead
And the rest of the COPD Project team for
Lambeth and Southwark
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