Addressing health inequalities (HI) by developing an new pathway into Pulmonary Rehabilitation (PR) for users of addiction Services in Islington. What has changed knowledge and confidence in Addiction Service staff in supporting the care of clients with long term respiratory disease / symptoms? (ID 457)
Whittington Health NHS Trust
Funding: NHSE funding to develop PR services has been used in part in North Central London to employ 2 Lead Physiotherapists who are investigating HI and developing pathways to address these
Abstract
NHSE funding has been used to address HI in PR provision across NCL. Research shows a high prevalence of chronic lung conditions among patients treated for opioids addiction, yet addiction services did not have direct access to PR referral. This cohort do not engage well with physical health services.A pilot was set up to reduce barriers to PR by accepting referrals which were initiated by the case workers at “Better Lives” (BL) addiction services, Islington. The staff were likely to know and have the trust of this cohort but didn’t necessarily have clinical knowledge / skills or understand the role and benefits of PR or how to promote it to their case managed clients. Several initiatives had been put in place to support staff in delivering this work.
A 7 question form (contained scales and open questions) was used to collect feedback from BL staff with a view to ascertaining any perceived changes in knowledge and confidence, any specific clinical impact that was noticed and to identify how future support should best be provided to address ongoing need.
Baseline confidence varied significantly across the group. (1-6 and 1-9 respectively on a 10 point scale for managing patients with breathless and explaining PR). 62.5% of established staff reported having better confidence over the 6 month period.
3 staff attended an actual PR class and identified this as the most significant factor in improving confidence. Otherwise, individual case discussions were cited as the most commonly helpful followed by regular attendance at MDT’s with programme feedback. Formal NCL wide training was shown to be the least effective intervention at improving confidence, but this must be looked at in the context of poor attendance.
Valuable learning will be used to shape the ongoing support for the BL service.
Conflicts of interest: None
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