PM Healthcare - Summer 2022

48 PM Healthcare Journal • Reduce the overall rate of exacerbations • Help improve the quality of life of people with respiratory disease and those close to them • Help to decrease the number of people dying prematurely from respiratory disease • Improve value for money from the investment in treating respiratory disease The advantages of a PCN Hub would be utilisation of existing workforce (team from GP practices), shared expertise, shared use of equipment and the ability to provide the service from a fixed or mobile site. This would also mean that skills would be retained in primary care with potential economies of scale and volume. Patients would benefit from equitable access to such a service. ARRS roles including physiotherapists, dieticians, social prescribers, mental health practitioners could be used to provide MDT approach for the more complex patients with respiratory disease. PCNs’ are also being encouraged to become more collaborative with other providers - community pharmacists may also be involved in providing smoking cessation services, inhaler technique checks, therapy reviews via new medicines services as well as providing flu vaccinations. The main limitations of such a service would be to recruit a suitable team given the current workforce issues within primary care. There would also be a need to assess capacity depending on prevalence of disease (asthma, COPD, other respiratory conditions). Also, there is no existing funding stream available to set up such a service. PCN pharmacists could be involved in carrying out respiratory reviews, inhaler technique checks and inhaler therapy optimisation. There are also workstreams around the ‘green agenda’ which could be tackled by these pharmacists. Secondary care-based Hub In some areas, secondary care teams provide a diagnostic and management service for respiratory patients. Due to the pandemic, such services may have been suspended but may now reopen. The main benefits of such services could be quality assured diagnostics and equitable access. Such services may already be centrally funded. The workforce would be mainly comprised of secondary care personnel. The concern would be that the services could be overwhelmed due to a large backlog of patients. These services may be place-based (at the hospital) and may prove difficult to access for older, frailer patients. Workforce issues may also limit the capacity of such services. Pharmacists could therefore provide a key role in restarting respiratory services by providing extra capacity at most clinical settings. The Primary Care Respiratory Society document ‘Fit to Care’ would be a great resource to help identify gaps in skills and knowledge for all pharmacists. As their confidence and competence increases, they could also use the resources in the document for bench marking purposes. 5 References 1. Written evidence submitted by Asthma UK and the British Lung Foundation (CBP0033): https://committees.parliament.uk/writtenevidence/38568/pdf 2. Spirometry commissioning guidance, NHS England, 2020: https://www.england.nhs.uk/wp-content/uploads/2020/03/spirometry-commissioning-guidance.pdf 3. Risk minimisation in spirometry re-start, The British Thoracic Society: https://www.brit-thoracic.org.uk/document-library/quality-improvement/covid-19/restarting-spirometry/ 4. Respiratory disease, NHS England: https://www.longtermplan.nhs.uk/areas-of-work/respiratory-disease/ 5. Fit to care: key knowledge skills and training for clinicians providing respiratory care, Ren Lawlor, PCRS, 2017: https://www.pcrs-uk.org/sites/pcrs-uk.org/files/resources/2019-FitToCare.pdf Published by Pharman Limited The Stable Yard, Vicarage Road, Stony Stratford, Buckinghamshire MK11 1BN Tel: 0333 800 2850 Homepage: www.pharman.co.uk E mail: [email protected] PM Healthcare PROGRESS THROUGH PARTNERSHIP