Changing places: a new role in an evolving respiratory service

Vertical integration and leadership

Tuesday, June 13, 2017

Dr Helen Ward is a Respiratory Consultant at The Royal Wolverhampton NHS Trust and Clinical Lead for vertical integration, and member of the BTS Models of Care Committee.

I started as a respiratory consultant at New Cross Hospital, Wolverhampton in February 2013. At my consultant interview I’d expressed my desire to develop closer working relationships with health care professionals within primary care and community teams as well as providing respiratory expertise outside of the hospital.

The vertical integration project is where several GP practices have integrated with the acute trust and community services.

I have since provided several community clinics based in GP practices with the practice nurses and now give a monthly joint clinic with one of the local palliative care consultants at the hospice in which we review patients with end stage lung disease. I chair a fortnightly chronic respiratory MDT where we meet with the community matrons, hospital respiratory nursing team, physiotherapists and oxygen lead to discuss patients in particular those with frequent admissions and end stage disease. I also chair a monthly Respiratory group which oversees respiratory services across Wolverhampton. The members include respiratory leaders locally from across primary, secondary and community services (including acute trust and CCG managers).

Due to my interest in integrated respiratory medicine, I was asked in January 2017 to be the clinical lead for vertical integration (VI) at our trust. The VI project is where several GP practices, 5 so far with others progressing towards it, have integrated with the acute trust and community services (which are already part of the acute trust).

The aim of vertical integration is to improve health care and its coordination for the local population.

As its clinical lead, my role is to oversee the planned clinical projects within the VI project including ensuring they have an appropriate outline and plan of the strategy and outcomes and that they progress in a timely way. I have had the opportunity to liaise with different teams in the community including Public Health and Hospice to plan joint projects.

The trust is hoping to become an Accountable Care Organisation and I am keen to be part of this major change in health care provision.

To ensure that I am up to date with the rapidly changing clinical model, I attend weekly VI team meetings which are chaired either by the Director of Integration or the VI Primary Care Directorate Manager.  I provide an update to the monthly VI clinical workstream meetings and also to the steering group chaired by the Chief Executive.

As part of my role it is important for me to develop closer working relationships across all of the Vertical Integration project including the GPs, practice nurses, community teams, Human Resources, Executive team, Public Health and the VI Primary Directorate Management team. I also have regular 1:1 meetings with the Medical Director and Director of Integration to support me in my developing leadership role.

In the future, the trust is hoping to become part of an Accountable Care Organisation across Wolverhampton, and I am keen to be part of this major change in health care provision if it is approved by NHS England.

My current new role has enabled me to develop further as a leader in a new, exciting and important change in health care provision. I am excited by the future and what it is going to bring!


Visit the New Models of Care programme page


Further reading:

Championing patient-centred respiratory care: Consultant-led integrated care in Telford

Consultant Nurses: reforming health services by working across professional and organisational boundaries

Achieving better integrated care: the unique role of community pharmacists