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To develop and implement a shared care pathway for patients with interstitial lung disease within the East of England Region

A Collaborative Working Project between Boehringer Ingelheim Limited (BIL), Royal Papworth Hospital NHS Foundation Trust (RPH), and Colchester General Hospital, East Suffolk and North Essex NHS Foundation Trust (ESNEFT), to operationalise a best practice shared care pathway for patients with interstitial lung diseases (ILD) - developed as a second phase follow up to a previous Joint Working Project 2021-20221.

ILD comprises a broad spectrum of conditions, all of which are characterised by inflammation and/or fibrosis of the lung with impairment of gas exchange, one of the commonest of these conditions is idiopathic pulmonary fibrosis (IPF). The NICE Quality standard for IPF specifies that services should be commissioned from and co-ordinated across all relevant organisations encompassing the whole IPF care pathway.2 A patient-centred, integrated approach to providing services is fundamental to delivering high-quality care to adults with IPF.2

IPF is diagnosed via a complex care pathway that includes primary, secondary, and tertiary specialist care involvement. These complexities contribute to the delay between the onset of symptoms and diagnosis, with 40% of patients nationally waiting for more than 2 years to be diagnosed3. Some individuals may also experience anxiety and depression and the all-cause mortality rate is 35%3. 

The COVID-19 pandemic created a backlog that has had a significant impact on NHS clinical services and caused patient appointments to be delayed. Both secondary and tertiary care have since seen an increase in referrals for patients with suspected pulmonary fibrosis. As a result, a more sustainable patient pathway is required to provide specialist ILD care to patients across regional networks and “future proof” the specialist ILD service to be able to meet and adapt to growing demands.

The pilot pathway will address health inequality in access to specialist care for patients with ILD, by establishing a multi-speciality model of care, that aims to provide optimal care for patients closer to home. The pathway reflects the complex needs of this group of patients and aims to achieve the below four objectives.

  1. Mobilise a shared care pathway that improves the quality of life for patients with ILD across the eastern region of England. This will include time to diagnosis, accessing treatments and follow up appointments.  
  2. Improve equity of access to ILD services and reductions in variations of care across the eastern region of England 
  3. Service and patient experience improvement through continuity of care from a multi-specialty and multi-disciplinary service, that demonstrates best practice in diagnosis, treatments, and management in patients with ILD
  4. Improvement in adherence to national quality care standards

The pilot project will commence in July 2023 and complete within 18 months.

BIL is proud to be collaborating with RPH and ESNEFT to design and deliver this quality improvement programme, to improve the health and quality of patients’ lives, with an ambition to become an exemplar service for other healthcare systems. 

References: 

  1. Royal Papworth Hospital NHS Foundation Trust, East Suffolk and North Essex NHS Foundation Trust, Boehringer Ingelheim and Wilmington Healthcare. Interstitial Lung Disease Integrated Shared-care pathway. Cambridge, UK. 2022. RPH Joint Working Project | Boehringer Ingelheim UK (boehringer-ingelheim.com)

  2. National Institute for Health and Care Excellence (2015). Quality standard (QS79) Idiopathic Pulmonary Fibrosis in Adults. Available at: https://www.nice.org.uk/guidance/qs79 (Last accessed July 2023)

  3. British Thoracic Society. BTS ILD Registry Annual Report. UK. https://www.brit-thoracic.org.uk/quality-improvement/lung-disease-registries/bts-ild-registry/.https://www.brit-thoracic.org.uk/quality-improvement/ 2021. (Accessed July 2023)

 

NP-GB-103742    July 2023