Abstract

Spirometry is a valuable diagnostic tool, however due to the covid pandemic was temporarily halted and services have not yet fully resumed. To help address spirometry waiting lists and to support restart, South Eastern Hampshire CCG commissioned Partnering Health Ltd [ https://phlgroup.co.uk/ ] to deliver a mobile spirometry service in 36 practices across 7 PCNs.
Work to operationalise the service started in August 2021, with the development of patient pathways, Standard Operating Procedures, purchasing of equipment, identification of vehicles capable of hosting the service and hiring of ARTP trained clinicians. Practices identified eligible patients needing spirometry from waiting lists or by Read code searches applied to the practice database. Patient lists were forwarded to PHL who organised and booked clinics.
So far, 363 tests (112 post bronchodilator and 251 reversibility tests) have been completed, 23 patients did not attend and 20 were not eligible at their appointment. All patients received a respiratory assessment, results were filed in the patient notes and recommendations were shared with the patient and their clinical team. Training and updates were also provided to practice staff if requested.
Challenges included difficulties in recruiting trained clinical staff which delayed the start of the service. Many practices did not have a clinician able to interpret spirometry, so this was completed by the clinician performing the test. Practical issues such as availability and parking issues, meant that a vehicle was not used for the service. Instead practices were able to accommodate clinics which was more comfortable for patients and cost-free. Additional expense and time were incurred due to covid-19 infection control procedures. Coordinating patient lists and clinics has proved challenging across multiple organisations. Feedback from patients and GP practices have been positive, with many reporting they would like the service to continue.