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A quality improvement project with Oxford University NHS Trust for patients with interstitial lung disease Joint Working Project Executive Summary.

Delivery of a quality improvement project through the development of a shared care service pathway protocol for patients with interstitial lung diseases (ILD) including idiopathic pulmonary fibrosis (IPF) across a local integrated NHS geography.

A collaborative joint-working project between Oxford University Hospitals NHS Foundation Trust and Boehringer Ingelheim Ltd (BIL).

Lung conditions, including lung cancer, are estimated to cost wider society around £9.9 billion each year. Respiratory disease affects one in five people in England and is the third biggest cause of death. Hospital admissions for lung disease have risen over the past seven years at three times the rate of all admissions generally and remain a major factor in the winter pressures faced by the NHS.1

Interstitial lung diseases comprise a broad spectrum of conditions, all of which are characterised by inflammation or fibrosis of the alveolar wall with impairment of gas exchange. One of the commonest of these conditions is idiopathic pulmonary fibrosis (IPF), which will be the primary focus for this pathway. Other ILDs will also be aligned with this pathway as a secondary objective. 2

IPF is a condition in which the lungs become scarred and breathing becomes increasingly difficult. It's not clear what causes it, but it usually affects people around 70-75 years of age and is rare in people under 50. IPF gets worse over time, although the speed at which this happens is highly variable.3

Most people with IPF have symptoms of breathlessness, which may at first occur only on exertion, and cough, with or without sputum. Over time, these symptoms are associated with a decline in lung function, reduced QoL and ultimately death. The NICE Quality standard for IPF specifies that services should be commissioned from and coordinated across all relevant agencies encompassing the whole IPF care pathway. A person-centred, integrated approach to providing services is fundamental to delivering high-quality care to adults with IPF.4

Oxford University Hospitals is a tertiary referral centre for individuals with Interstitial Lung Disease (ILD) across Oxfordshire, Berkshire, Buckinghamshire and Northamptonshire. The ILD service is one of a small number of specialist centres across England, which provide a specialist multidisciplinary service for diagnosis, treatment and ongoing care for individuals with ILD.5

This project between Boehringer Ingelheim and Oxford University Hospitals NHS Foundation Trust aims to develop and deliver a quality improvement project through development of a shared care service pathway protocol for patients with ILD, including introducing measures to deliver urgent access day care for patients with ILD experiencing an exacerbation of their illness, increase utilisation of functional virtual care and home monitoring and identify the requirements for formalised shared care.

Having initially gone live in October 2020, following a delayed commencement due to the impact of the COVID-19 pandemic, the pilot project became operational in June 2021 and will run for up to a further 12 months.

Boehringer Ingelheim Ltd is proud of our ongoing partnership with the NHS and believe we share one fundamental principle with the NHS: putting patients at the heart of everything we do and working together to improve the health and quality of patients’ lives.

References:

  1. The NHS Long Term Plan. Available at: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf (Last accessed September 2020)

  2. NHS England (2018). Schedule 2 Service Specification: Interstitial Lung Disease Adult. Available at: https://www.england.nhs.uk/wp-content/uploads/2018/08/Interstitial-lung-disease-service-adult.pdf (Last accessed September 2020)

  3. NHS Inform (2019). Idiopathic pulmonary fibrosis. Available at: https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/idiopathic-pulmonary-fibrosis (Last accessed September 2020)

  4. National Institute for Health and Car Excellence (2015). Quality standard (QS79) Idiopathic Pulmonary Fibrosis in Adults. Available at: https://www.nice.org.uk/guidance/qs79 (Last accessed September 2020)

  5. Oxford University Hospitals Interstitial lung disease service. Available at: https://www.ouh.nhs.uk/services/departments/specialist-medicine/respiratory-medicine/ild/default.aspx (Last accessed September 2020)

 

NP-GB-102411 V2  November 2022