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Thursday 29 September 2016
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Fair weather for a Devon practice's COPD patients

A GP practice in Devon has taken part in an innovative and award-winning project with the Met Office, South West SHA and the Improvement Foundation.

Chilcote Surgery was already working with the Improvement Foundation's long-term conditions collaborative to reduce hospital admissions and improve the quality of life for those with chronic obstructive pulmonary disease (COPD), when the opportunity arose to work with the Met Office.

Certain types of weather, especially extreme temperatures, can cause the symptoms of people with COPD to worsen. By using Met Office twice-weekly weather forecasts, the practice was able to help patients identify any weather conditions that may exacerbate their COPD symptoms and thereby take appropriate action to manage their condition. The programme resulted in an 82% reduction in COPD-related hospital admissions between September 2004 and 2006.

As a result, the project has been awarded the Department of Health's (DH) Innovative Service Award as part of its Health and Social Care Awards scheme. Due to the success of the project, a commissioning framework for COPD has been developed to roll out the model of improvement across the Torbay Care Trust.

Alison Stephens, programme manager for the Improvement Foundation, said: "Our key aim now will be to develop this work further, locally rolling out the exemplar model to all practices in the care trust through a locally enhanced service commissioning framework. With the chief executive's support, this service redesign model clearly underpins the DH's strategic plan for practice-based commissioning (PbC) development and the benefits realisation by spreading this work is significant.

"The work of Chilcote Surgery is an outstanding achievement. The practice has successfully demonstrated how partnership working and effective service redesign can transform the lives of patients with COPD," Alison continued.

Dr Tish Laing-Morton, Clinical Director at the Met Office, said: "This innovative collaboration with the NHS and the Improvement Foundation has demonstrated benefits to the NHS and patients with COPD. The Met Office Health Forecast service helps patients to understand their condition, know better how to self care, and achieve their potential for independence and wellbeing."

The work of Chilcote Surgery was supported and enhanced by the work of Torbay Care Trust, which established special procedures and appointed two community COPD nurse specialists to integrate services across the region.

Through the project, COPD patients were presented with special information packs, including room thermometers and a guide of action they could take to avoid symptoms worsening and requiring professional intervention. The practice developed a COPD register to identify those most at risk and appointed a Specialist Nurse Coordinator to make it easier and quicker to communicate with patients.

Where appropriate, some patients are also provided with personal management plans along with medication. When symptoms occur, patients are then able to start using their medication far more quickly, alerting their nurse or GP as soon as they do so to ensure they are effectively monitored.

Dr Pete Moor, GP for Chilcote Surgery, said: "We have been delighted with the results of the Met Office pilot scheme. Not only is there clear evidence for a reduction in hospital admissions but we have noticed far less demand for urgent appointments or visits for exacerbations of COPD. It even helps  Quality and Outcomes Framework (QOF) points."

Julia Avery, Practice Nurse for Chilcote Surgery, said the project has meant real benefits for patients. "The timing of the Met Office pilot was perfect for us, as we were already focusing efforts on identifying and supporting our patients with COPD through our work with the Improvement Foundation.

"We had already established a specialist nurse team and contacted every patient with COPD to alert them to the fact that we were taking a more proactive approach to managing the condition. The Met Office pilot put us in direct contact with meteorology experts who, twice a week, provided us with detailed briefings including weather forecasts and rates of infections such as flu within the community. That information was then fed to our patients, together with support and advice about the possible implications for their health.

"The pilot was also very much about empowering patients to manage their condition themselves and, after meetings with every patient, we were able to provide specialist advice and resources via the Met Office, including room thermometers.

Julia continued: "The key aim was to reduce admissions and the impact was very marked. For the winter prior to our involvement in the pilot we recorded 35 admissions for patients with COPD; that fell to five for the following winter.

"Patients have told us that the project has made a real difference to their lives, by enabling them to take simple, practical steps to pre-empt situations which could exacerbate symptoms and therefore gain greater control over the condition."