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Commissioning for Value
Respiratory Pathway
Clive Newman, Director of Transformation
Hardwick 2012/13 position based upon C4V indicative data,
GEM deep dive evidential data and Right Care analysis:
• Higher than average prevalence of COPD (coal mining legacy)
• Higher than average smokers, especially during pregnancy
• Lower than average correct diagnosis of COPD.
• Lower than average using a self management plan.
• Higher than average non elective admissions: respiratory main cause
and rising.
Four fundamental elements for successful change:
• Supportive senior executive team willing to take risk based on sound
• Focused project manager to deliver in systematic methodical manner
fully inclusive of all stakeholders.
• All clinicians accepting and understanding its priority for improved
patient outcomes.
• Solid and consistent patient engagement and representation at all levels,
supported by the British Lung Foundation.
What has NHS Hardwick achieved to date?
Respiratory delivery group; all stakeholders
Spirometry competency assurance
COPD self care diaries with bespoke welcome section & DVD
Regular programme of educational events
3 active Breathe Easy Groups
Smoking cessation programme ; CFC & Derbyshire Tobacco Alliance
Improved pulmonary rehab provision; excellent patient outcomes.
Designated respiratory medicines management lead
Increased nebuliser access; direct reduction in NE admission
Production of annual report to detail objective progress
BLF to perform next evaluation
Targeting of undiagnosed
Hardwick 2014/15 respiratory position
• Reduction in activity and spend 2013/14 - £170,000
• Predicted reduction in activity and spend for 2014/15 - £410,000
Patient story: the most important evidence!