Asthma Project Update

Dr Richard Iles, Clinical Lead for Paediatric Asthma Programme,

EoE SCN Maternity, Newborn, Children & Young People

Local Updates

• Working closely with Respiratory SCN

• One “size” does not fit all

• Working as advisors / project design / overview

• Need to increase & expand “advisory” group

Local Updates• Active “project management” with CCGs

• West Suffolk

• Bedfordshire

• Cambridgeshire and Peterborough

• South Norfolk

• Addenbrookes A&E

Update on national asthma collaborative project

Update on national asthma collaborative project

12 SCN and senate areas, broadly based around major patient flows

Team and Partners • Jackie Cornish

• Mike Morgan

• Niall McDermott

• Katie Walkin

• Lorraine Comley

• Richard Iles

• Linda Pearce

• Louise Raybould

• Alex Burroughes

• Joanna Lynne

• Asthma UK

• BTS / BPRS

• PCRS

• Education for Health

aileen.muir@brit-thoracic.org.uk

New Commissioning 2016

• Best Practice Tariff

• A named paediatrician with a specialist interest in asthma

• A named specialist asthma/respiratory nurse

• Take part in the BTS paediatric asthma audit

• Provide evidence of inhaler technique review and the presence of a personalised action plan for each admitted / clinic patient.

• See in Clinic in 1 month

• The CQUIN

• designed to incentivise providers to deliver quality and innovation improvements over and above the baseline requirements set out in the NHS standard contract, and will complement the best practice tariff for secondary care,

• It is designed to be applied to a regional referral or tertiary level centre.

• It defines the structure and activity of the clinic

CQUIN

• Asthma Consultant

• Asthma Nurse

• Allergy Consultant ( 0.1WTE)

• Specialist Physiotherapist

• Specialist Psychologist

• Pharmacist

CQUIN Principles • 70 per cent funding to the assessment and investigation of children with severe and

difficult asthma (home visits, GP information on compliance, education, monitoring)

• 10 per cent funding for evidence of a commitment to ongoing education of the

networked secondary care units within the region, and be enabled to audit the

educational achievement. This should be in close alignment and reportable to the

local CCGs / area team.

• 10 per cent funding for evidence of a commitment to ongoing assessment of

networked secondary care unit activity within the region, and data entry into a National

Severe paediatric asthma registry. Accountable to local CCGs, and area team.

• 10 per cent funding for strong communication structure with the patients secondary

and primary care providers, school and above all the child and family.

EOE CCGs compared to EU27/28

Admission rates IMD

Admission rate, coded

against EU27

Admission rate, colour coded

against Iceland (EU28 lowest)

Admission rate, colour coded

against Austria

Admission rate, colour coded

against Portugal

Admission rate, colour coded against

Finland

Admission rate rank, colour coded against

England average

NHS Basildon and Brentwood 17.6 113 113 113 113 113 17

NHS Bedfordshire 13.5 170 170 170 170 170 75

NHS Cambridgeshire and Peterborough 15.3 198 198 198 198 198 105

NHS Castle Point, Rayleigh and Rochford 12.2 158 158 158 158 158 65

NHS Corby 26.5 197 197 197 197 197 103

NHS East and North Hertfordshire 12.1 121 121 121 121 121 24

NHS Great Yarmouth and Waveney 24.6 244 244 244 244 244 142

NHS Havering 16.8 101 101 101 101 101 12

NHS Herts Valleys 11.2 114 114 114 114 114 19

NHS Ipswich and East Suffolk 15.7 184 184 184 184 184 87

NHS Luton 26.3 261 261 261 261 261 155

NHS Mid Essex 11.9 129 129 129 129 129 28

NHS Milton Keynes 15.6 200 200 200 200 200 106

NHS Nene 16.9 185 185 185 185 185 90

NHS North East Essex 19.2 166 166 166 166 166 70

NHS North Norfolk 16.1 144 144 144 144 144 49

NHS Norwich 20.8 147 147 147 147 147 50

NHS South Norfolk 13.3 179 179 179 179 179 81

NHS Southend 23.6 157 157 157 157 157 62

NHS Thurrock 20.1 141 141 141 141 141 44

NHS West Essex 15.4 133 133 133 133 133 33

NHS West Norfolk 20.8 342 342 342 342 342 187

NHS West Suffolk 13.6 376 376 376 376 376 194

CCG engagement and next steps

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CCG engagement and next steps

• West Suffolk

• Bedfordshire

• Cambridgeshire and Peterborough

• South Norfolk

• Addenbrookes A&E

Old Workstreams

• Workforce, Requirements, Training & Education

• Communication & Transition

• Prevention and Self-Management

• Effective Commissioning

• Specialist Medicine CQUIN

• Paediatric Asthma Best Practice Tarrif

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New Workstreams

• Local Networks

• Primary and Secondary Care interface

• “Education” Hubs

• “Clinical” Hubs

• HDU Network

Education

• Education for Health Project

SCNs working with Education for Health to develop e-learning modules

• CAKES