Breakout 4.2 Primary Care management of COPD in Mansfield and Ashfield Nottinghamshire - Rachel Walters, Kirsty Ball Respiratory Nurse Educator Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013, Guoman Tower Hotel, London How to deliver quality and value in chronic care:sharing the learning from the respiratory programme

1. Primary Care
Management of COPD
in
Mansfield and Ashfield
Nottinghamshire
Rachel Walters – Respiratory Nurse Educator
Kirsty Ball – Support and Development Manager
Local aims and objectives
Reduce
variation in
management
and Improve
Reduce outcomes patient
unplanned confidence in
admissions self-
management
To improve the
Reduce Primary Care Improve
spend on management patient
prescribing of patients experience
with COPD
Ensure all patients
have accurate Improve skill,
diagnosis, knowledge and
treatment, self- confidence of
management Primary Care
Provide clinicians
and an action appropriate
plan resources to
patients
and staff
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2. What did we do?
Reviewed
Trained the
the COPD
Identified Primary Care
registers Pharmacists
COPD health (Respiratory
needs in M&A on COPD
Nurse and prescribing
Pharmacist)
Created Trained the
resources for Completed Community
Consulted patients and Respiratory Pharmacists on
Breathe Easy inhaler
Practice staff Nurse clinics
technique
(shadowed by
Practice Nurses)
Met with the
Practices to Completed
understand the staff training
issues relevant for GPs and
to them Nurses
What did we find?
After a notes review of 484 patients on the COPD Register:
• 8% were removed from the Register
• 42% needed a Respiratory Nurse Review
After reviewing 128 of these patients in house:
• 26.5% were removed from the COPD Register
• 3.7% had an Asthma diagnosis added
• 2.4% had an Asthma diagnosis removed
• 66% had a medication change
• 28% were offered Pulmonary Rehabilitation
• 20% prescribed anticipatory meds and Action Plans given
• 21% were referred for further investigations
• 11% were referred to secondary care
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3. What did we achieve?
• Improved diagnosis and treatment of patients (value pyramid)
• Non-pharmacological; flu vacc, smoking, PR, keeping
active, Breathe Easy
• Pharmacological
• Improved patient knowledge about the disease and self-
management (tested by the validated LINQ score)
• Up-skilled and increased confidence of the Primary Care
workforce
• Comprehensive resource toolkit for Practices and patients
• Reduced prescribing spend; saving of £40 per COPD patient
on register
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4. Thank you
Rachel Walters
Respiratory Nurse Educator
Mansfield and Ashfield Respiratory Service
Rachel.Walters@nottshc-chp.nhs.uk
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