IMPRESS (IMProving and Integrating RESpiratory Services in the NHS)
A collaboration between British Thoracic Society (BTS) and General Practice Airways Group (GPIAG).
Our aim is to drive high quality patient-centred care across the traditional boundaries of secondary and primary care, integrating and improving the services for people with respiratory disease. This model of working together systematically across traditional health care boundaries is new and exciting and we will be inclusive in our approach, involving patient, lay, management and other constituencies in our work. We have taken advice from senior managers in PCTs and Hospital Trusts and our first publication on our website is a Jargon Buster (updated June 2007) (PDF, 5MB) which seeks to explain "the new NHS" to clinicians and others, giving respiratory examples.
We will shortly publish a Statement on Criteria for Hospital Referral, Admission, Discharge and follow up for adults with Respiratory Disease, commissioned by the BTS Standards of Care Committee in 2006. Much of the initial work of IMPRESS will focus on COPD, and we are working closely with the NSF COPD team. We are interested in exploring how respiratory networks might be used to support the implementation of the NSF. We are aware that things are not happening in the same way and at the same pace throughout the UK, but hope that what we are doing is of general, as well as specific, benefit as the work gathers momentum.
IMPRESS has published dos and don'ts in procurement, based on a case study of the procurement of a new COPD service. It is a useful practical guide to complement the new PCT guide to procurement.
IMPRESS update - March 2008
-
We sent a detailed response to the Darzi team that highlights the challenges and opportunities for respiratory care which has been well received by a number of audiences including SHAs and the Royal College of Physicians. This could be used as a starting point for local discussions about a respiratory strategy. We included as appendices, recommended standards for pulmonary rehabilitation, and Martyn Partridge’s work on the role of a consultant in integrated care.
-
New roles such as consultant in integrated care, and GPwSI in respiratory medicine were discussed at our meeting on Integrated Care at the Royal College of Physicians on 6 March. We have drawn this to the attention of the NHS Alliance, that is also looking at models of integrated care. More information.
-
We have publishedguidance for commissioners on key competences and standards for the respiratory workforce. This asks eight questions of commissioners and offers 5 standards.
-
To coincide with the publication on 26 March of the NICE Health Technology Appraisal on continuous positive airways pressure CPAP, IMPRESS has supported the publication by the BTS of a specification for sleep services.
-
We supported the production of referral guidelines published in Thorax this month, and have complemented this with a best practice guide to the content of a referral letter.
-
We have made detailed submissions to the PbR team on coding and tariff unbundling issues to support better commissioning of respiratory care. There is a long lead time to implementation, but we are arguing for respiratory hospital at home to be a priority for an unbundled tariff given the robust evidence base for its effectiveness.
-
As part of this, we want to draw commissioners attention to the possibilities of more sophisticated contracting, such as incentivising the appropriate use of telephone consultations as part of the shift of outpatient care. We have a drafted a position paper on the shift of outpatients, to be published shortly and would welcome examples of successful shifts, including how the contract supported this.
-
We have also become aware of the lack of convergence between the evidence bases used by some commissioners, and that used by clinicians for decision-making. We are therefore reviewing how best to ensure that evidence from British Thoracic Society and General Practice Airways Group conferences and publications gets into the domain of managers and commissioners. Equally, we are scanning the NHS websites for information about new service models in respiratory care, to ensure that the evidence from these is shared across the clinical community.
-
We are in conversation with a number of PCTs about developing evaluation criteria for the evaluation of COPD services.
What next?
-
We have focused on COPD, in preparation for the NSF, and will continue to do work – such as produce a best practice guide to commissioning COPD services.
-
We will be working with Asthma UK to produce guidance on asthma care pathways
For more information on any of these, please see our redesigned website.
Network website: www.impressresp.com
Network contact: Sian Williams, sianandhahn@blueyonder.co.uk