Accelerating access to specialist care for asthma patients through innovative pathway transformation (ID 477)
The Innovation Agency (Academic Health Science Network for the North West Coast)
Funding: This project was funded by the NHSE Accelerated Access Collaborative's Rapid Uptake Product Programme Pathway Transformation Funding
Abstract
Introduction and Objectives: The Severe Asthma Service (SAS) covers Cheshire & Merseyside ICB, with 128,811 patients on the asthma register. Evidence suggests that 5% (6,440) have severe asthma, of these 18% (1,180) are eligible for biologic therapies, which could have a significant impact on patients’ quality of life.Before the project, only 50% patients in Liverpool were established on severe asthma therapies.
Methods: A flow diagram illustrating the severe asthma pathway is included as figure 1. The redesigned elements are highlighted on the key.
The revised pathway aimed to provide specialist in-reach support into PCNs to:
• Provide primary care with education on improving adherence and optimising inhaler therapy
• Expedite biologic initiation for those eligible
• Improve homecare and use of technology (NuvoAir) to enhance the care experience and remotely monitor patients prior to biologic therapy initiation
The pathway also included in-reach into secondary care to support MDTs and expedite referrals to the SAS.
To support education in primary care around severe asthma, an educational package, comprising videos and a podcast, was produced (see figure 2).
Results: The re-designed pathway released resource to reduce waiting times from referral to review, from 70 to 18 days. It also reduced waiting times from referral to first injection, in eligible patients, from 167 to 53 days.
In-reach into one secondary care Trust will result in it becoming a prescribing site for biologics.
Conclusions:
• The work highlighted a proof-of-concept regarding roll-out of the pathway to a wider population including innovation and partnership working and formed the basis for a funding bid, to spread this approach across the ICB footprint.
• Written/ recorded guidance is vital to support education
• Wider staff roles, such as Physician Associates and Clinical Pharmacists, can support specialist areas like asthma
• Remote review works
A poster based on this work will be presented at the HSR conference 4-6 July.
Conflicts of interest: None
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