Aneurin Bevan University Health Board, Powys Teaching Health Board, Hywel Dda University Health Board and GSK are undertaking a joint working innovation project with the aim of delivering improved Asthma and COPD care for patients who have not been seen in general practice in the previous 12 months. This involves a balance of contributions with the pooling of skills, experience and resources.

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The project aims to support the delivery of the NHS Wales Community Pharmacy Inhaler Review National Enhanced Service by delivering increased quantity of reviews, HCP education and measuring the impact of community pharmacies delivering care for this group of Asthma and COPD patients, using the Asthma Control Test or COPD Assessment Tool and a patient reported experience questionnaire. The joint working collaboration includes three Health Boards, the British Lung Foundation, the Welsh Respiratory Health Implementation Group, Respiratory Innovation Wales, Life Sciences Hub Wales, Community Pharmacy Wales, Health Education Improvement Wales, Primary Care Respiratory Training Centre and GSK.

The project will run from 13 January 2020 to the end January 2021.

Key Objectives:

  • Improve the standard of Asthma/COPD care in the identified patient cohort (patients not seen in general practice in previous 12 months) resulting in an improvement in Asthma/COPD control/impact on patients’ lives
  • Demonstrate that delivering an inhaler review within community pharmacy is a valued use of limited NHS resource
  • Demonstrate the value of the use of ACT/CAT in the community pharmacy setting, as part of a patient inhaler review, as an aid to decision making in primary care
  • Improve the knowledge, skill, confidence and motivation of HCPs delivering the ‘Level 1&2’ Inhaler Reviews
  • Through the successful delivery of the Joint Working Project demonstrate the value of collaboration between the NHS, third parties, community pharmacy and GSK and thus build trust with regards to future collaboration

Intended Benefits:

For the patient: 

  • More patients would receive an Asthma/COPD Inhaler Review based on a validated quantified assessment of their Asthma control or impact of COPD (e.g. ACT/CAT), including personalised care and training in how to use their inhaler effectively. Their inhaler review will be conducted in a location potentially more accessible, than their usual GP practice (This does not replace the GP Practice review but identifies those patients that do not attend annual reviews and raises patient awareness of symptom control and what to do if they have an exacerbation)
  • Patients with uncontrolled Asthma/COPD will receive education and if required/as appropriate a device/therapy change, through the pharmacist ‘GP Action’ recommendations implementation
  • Patients gain a tool to self-assess and self-monitor their Asthma/COPD control; this may help raise patient expectations of control and impact possible

For the NHS:

  • Increased reviews could reduce inequality of Asthma/COPD care and improve outcomes including improved Asthma/COPD control/impact, reduced medicine wastage, increase appropriate prescribing, increase positive patient experience/satisfaction.
  • Access to an independent evaluation of the service at Health Board and Pharmacy level and an opportunity to expand innovative solutions at scale.
  • Tools to measure the impact of Community Pharmacy intervention, over time (ACT/CAT) and further evidence for consistent adoption of ACT/CAT across Wales
  • Supports Prudent/Value-Based Healthcare and patient self-care/management

For GSK: 

  • Build Trust and gain evidence of working in a collaborative nature with the NHS and other parties to benefit the patient, NHS and GSK, by implementing innovative solutions at scale.
  • Reviews of patients who have not been seen for 12 months could result in an increased opportunity for medicines optimisation in line with the local HB / ’All Wales Asthma/COPD Management and Prescribing Guidelines’ which include GSK’s medicines, as well as medicines from other pharmaceutical companies. (12 weeks following the inhaler review patients will be asked via a PREMs what action was recommended and what was the outcome)
  • Data to support adoption of ACT/CAT consistently at scale, in primary and secondary care in Wales as a valuable tool to monitor Asthma/COPD control/impact.

Project membership includes, the Life Sciences Hub Wales, Respiratory Innovation Wales, Community Pharmacy Wales, and the British Lung Foundation.

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