Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis and emphysema which affect normal breathing and for which there is no cure. The COPD Mortality Project was established in September 2014 to review COPD end of life care at Lancashire Teaching Hospitals NHS Foundation Trust.
A local multidisciplinary Heath Economy project team was established to review current primary, community, ambulance, acute service and palliative care service pathways for people with advanced COPD/Bronchiectasis. The Central Lancashire Health Economy Partners include Lancashire Care Foundation Trust, Greater Preston CCG, Chorley & South Ribble CCG, General Practice Representation, St Catherine’s Hospice, Lancashire Teaching Hospitals NHS Foundation Trust and North West Ambulance Service.
The team’s ambition has been to ensure effective care and treatment is being consistently provided in the appropriate environment for people with advanced COPD at the end of life stage. The main aim of the project is to enable 100% of patients in this diagnostic group, with Preferred Priorities of Care (PPC) to die in their preferred place..
In order to explore the current COPD pathway and identify areas for improvement, service mapping events were undertaken in mid-November 2014.
Patient engagement was also central to the service review with a relative’s view of the service presented at mapping events. Focus group activities with patients and families were undertaken in January, and outcomes from these will influence the ongoing planning of service changes and improvements to care.
Changes so far
As a result of the review, changes have been made.
Health economy partners have reviewed the relevant outcomes for their organisation and are in the early stages of taking appropriate actions, which are communicated at the Core Project group meetings.
A pilot is currently in progress within the acute trust to improve the identification of patients reaching end of life in relation to the Gold Standards Framework, through a multidisciplinary and health economy team approach. The pilot will be then extended across sites.
Communication and information management systems are being explored to share the outcomes with partner organisations in line with the local Transform project and regional electronic Palliative Care Coordination system (EPaCCS).
A wider benefit of the project has been the development of excellent relationships and working practice through networking with health economy partners, which has resulted in early successes of the project and will be key to continued changes in services supporting this group of patients and families.