Wirral Alliance, a group of seven GP practices with a patient population of 40,000 and 789 diagnosed with COPD, rolled out a nurse-led initiative PACE in April 2012 to improve patients’ quality of life and reduce COPD hospital admissions.
By equipping patients to control their COPD and reduce the severity and number of exacerbations, the NHS can avoid unnecessary costs and more importantly, help patients avoid the distress and disruption of an emergency hospital admission.
Nurse-led monthly clinics and patient group support meetings are held to identify the patients who are at most risk of hospital admission.
A nurse offers a one-hour review in the GP practice, providing a full respiratory assessment.
Since implementation the annual cost of COPD admissions for Wirral Health Alliance consortium has declined through reduction of emergency hospital admissions, exacerbations in patients and GP emergency appointments.
Patients report improved quality of life resulting in feeling more confident and healthier, with new friendships and social networks formed with peers met at pulmonary rehabilitation. Fifty per cent quit smoking.
Future plans include a telephone COPD helpline for advice from a respiratory nurse; more pharmacy involvement in monitoring medications; pulmonary rehab courses; and more rapid follow ups post-exacerbation and post-hospital admission.