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Innovative COPD trial in Bordon GP practice

Badgerswood and Forest surgery are working with specialists from Portsmouth to identify patients suffering from Chronic Obstructive Pulmonary Disease (COPD) and deliver appropriate care in their own GP surgery. 

The project, known as MISSION (which stands for Modern Innovative SolutionS in Improving Outcomes iN COPD), identifies local patients with a history of breathlessness, recurrent chest infections (e.g. needing frequent antibiotics and steroid prescriptions) and offering them a full day of specialist assessment, education and self-management skills all at their GP surgery.

Chronic Obstructive Pulmonary Disease (COPD) is the name given for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. COPD is mainly caused by smoking and is more prevalent in deprived areas. Early diagnosis is important to ensure the right treatment slows deterioration in health. In Hampshire, some 22,400 people have been diagnosed with COPD, which includes diseases such as emphysema and chronic bronchitis - and there are fears that potentially more than 12,800 people don’t know that they have the condition.

Patients invited to a MISSION clinic will have the opportunity to have their medication, lung function and inhaler technique checked, to be reviewed by a Respiratory Specialist Doctor and receive personalised advice on how to manage their condition. The aim of this project is to see whether this style of patient care can improve patients’ quality of life and prevent them from being admitted to hospital. It is supported by Wessex Academic Health Science Network (AHSN), a health innovation organisation established to improve health outcomes for people in Hampshire, Dorset, south Wiltshire and the Isle of Wight.

Dr Anthony Leung, Badgerswood GP and project lead explained, “By taking part in this project, Badgerswood is offering better care to patients. We have been able to purchase a spirometer (lung testing machine), which will help our GPs diagnose and monitor people with breathing conditions.  We have already received great feedback from patients about this new approach to their care. They say it’s exactly what they need, and avoids lengthy assessment waiting times and unnecessary journeys to Portsmouth.”

Queen Alexandra Hospital in Portsmouth has a specialist clinic which enables each patient to see up to 10 specialists in one day.  Previously, they would be referred by their GP, wait up to 12 weeks for a consultant appointment and then receive ongoing appointments over a period of 3-4 months.  This new method condenses the whole process into a half day assessment clinic where all the tests for investigating COPD conditions can be done in one session.  Patients are correctly diagnosed earlier, receive the correct treatment, and, by learning how to manage their condition better, ultimately prevent flare-ups of their disease and stay out of hospital. 

This project complements the Better Local Care strategy to support professionals in working seamlessly to provide specialist care closer to home.  It builds on a wider project to redesign the way COPD patients are treated, eliminating the need for the GP to refer the patient to hospital.  The next stage of this project will see the initiative rolled out more widely across East Hampshire.

Dr Kathryn Bannell, Better Local Care GP Lead for East Hampshire, said, "MISSION COPD is an exciting example of improving the way we delivery care for people with COPD.  It brings together the specialist care teams, primary care teams and patients at the local GP surgery to ensure patients with this long term respiratory condition receive earlier diagnosis and treatment. It is a great example of local NHS organisations working closely together to deliver a new service to the local population. Doctors, nurses and specialists are part of the same extended team to make care more straightforward for patients with complex health needs.  MISSION COPD also ensures earlier access to specialist care, which is key to promoting early diagnosis and avoiding conditions becoming more complex.”

The MISSION team and Wessex AHSN have produced an informative video which clearly explains the concept and features positive feedback from some of the patients and staff involved.  The video can be viewed at http://wessexahsn.org.uk/videos/show/171