Dudley Strategy for Tackling Health Inequalities 2010-15

There is a weak correlation between deprivation and emergency admissions forCOPD, with GP practices with a higher percentage of their population in the mostdeprived quintile showing slightly more tendency to have higher rates of emergencyadmissions for COPD. (Figure 6)COPD SERVICES IN DUDLEYCOPD LESA COPD Local Enhanced Service (LES) is in place that provides proactivemanagement of patients with COPD to reduce hospital admissions byreducing and minimising duration of exacerbations.Each practice has developed a „high risk of admission‟ register so that thesepatients can be easily identified.The initiative has seen the introduction of a self management plan for everypatient as well as the provision of standby antibiotics/steroids for patients.Additionally a web based intranet site has been developed detailing guidelinesfor the treatment and management of COPD patients which is accessible toall health professionals across the borough.Current data is indicating that there are positive outcomes from this serviceand a reduction in admissions to hospital for COPD.The COPD LES is closely monitored and the numbers of reviews and patientadmissions to hospitals are brought to the attention of the practices anddiscussed.Other initiativesA lead Respiratory Nurse for community nursing linking in with the DudleyRespiratory Assessment Service. The role includes support to generic staffincluding primary care practitioners, community case managers and othercommunity staff.COPD personal management plans (part of LES)All the practices to have at least one member of staff to have undertakentraining and have the COPD Diploma.Pulmonary rehabilitation services are available at a range of communityvenuesOxygen therapy assessment service with full patient support provision.Smoking cessation servicesLocal clinical guidelines agreed between primary and secondary careThe National Strategy for COPD consultation document was issued this year andscrutinized via the Respiratory LIT. In Dudley COPD has had a concerted focusdriven by the LES. There are further areas that Dudley needs to take forward e.g.end of life care and identifying people with COPD not known to practices.The performance of COPD services and review of the pathway is reviewed by theRespiratory Local Implementation Team that meets quarterly and includes bothprimary and secondary care clinicians, pharmacists, public health, nurses andcommissioners,141