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Medicines optimisation for COPD in primary care

A Darzi Fellowship project by Dr Nicola Aloysius

Monday, November 6, 2017

A project promoting clinician engagement in transformation and developing quality improvement activities within primary care.

Hi Nicola, welcome to Respiratory Futures and thank you for speaking to us about your work. 

What is your current STP/CCG role and how did you become a Darzi Fellow?

I am a GP and Respiratory Clinical Lead for Surrey Downs Clinical Commissioning Group. This year, I am undertaking a Darzi Fellowship in Clinical Leadership working for Surrey Heartlands STP Academy. I became a Darzi Fellow as it is a fantastic opportunity to take part in a change project within the NHS, learning on the job and receiving teaching on systems leadership and change management. 

I plan to help develop and implement initiatives which will support medicines optimisation of COPD within primary care

Could you give an overview of your Darzi project? 

My project is connected to the newly created Surrey Heartlands Academy. This Academy supports clinicians with the adoption and spread of innovation and best practice and it also acts as an enabler for transformation in Surrey Heartlands STP.

My project involves promoting clinician engagement in transformation and developing quality improvement activities within Primary Care. As part of our improvement activities I am working on medicines optimisation of COPD which is great as I can use my experience gained from being Respiratory Clinical Lead for Surrey Downs CCG.

What are you hoping to achieve?

Data from Surrey Heartlands shows the management of COPD is a key area for improvement. I plan to help develop and implement initiatives which will support medicines optimisation of COPD within primary care so that we can improve outcomes and the experience of care for our patients with COPD.

I am focusing on:

  • Working with patients with COPD, and clinicians who are passionate about the condition, to develop educational sessions for primary care colleagues. These will focus on the GOLD guidance, inhaler technique, support for mental health and appropriate prescriptions for rescue packs.

  • Developing a COPD template for primary care computer systems:

            - To support clinicians to use the GOLD guidance

            - Ask questions that help stratify patients into A, B, C, D grading

            - Prompt consideration for COPD medication review and provide algorithm

            - Prompts to ask about anxiety and depression;

  • Evaluate the impact of these initiatives and use this to develop a case for sustainable support for primary care.

How can readers of Respiratory Futures help your work?

Really great work is going on all around the country, and I would like to hear from people who can advise me on what has worked well in their area. It would really help if people could:

  • Share recommendations on what they think would help primary care to manage COPD
  • Share a template which incorporates the GOLD guidance for management of COPD
  • Share their education techniques which improved prescribing for COPD
  • Whilst researching my project I have spoken to people with COPD, some of whom said that they did not receive enough information about their diagnosis and had a significant wait for pulmonary rehabilitation. As such, I’d like to hear whether people think CCGs should offer a COPD education and self-management programme (an equivalent of DESMOND) at diagnosis.

All feedback is welcome to the above points by 8th December 2017.

Thanks for joining us, Nicola.