Nurses are among six respiratory champions who are working to improve outcomes for people with lung conditions as part of a recently extended pilot project.
The programme, led by the charity Asthma + Lung UK and funded by AstraZeneca, was initially going to be 12 months but has now received backing for another year.
“It’s given me that platform and that bit of extra confidence that actually, no, I am good enough to do this”
Victoria Campbell
It has seen six respiratory healthcare professionals in different integrated care system (ICS) areas in England being appointed to the role of a respiratory champion.
As part of this, the champions have been supported to create action plans for improving respiratory outcomes in their area and are funded for one day a week to work on their projects.
The ICB areas covered are those with high levels of deprivation due to the link between deprivation and poor lung health, such as asthma and chronic obstructive pulmonary disease (COPD), according to the charity.
Among the champions are two nurses as well as a physiotherapist, pharmacist, general practitioner and physician.
The whole programme is overseen by respiratory nurse specialist Claire Fisher, who had already worked with the charity on its helpline before taking on this role.
Speaking to Nursing Times, Ms Fisher said the champions programme came about as a way to address the “really stark figures of respiratory in England”.
Claire Fisher
She noted that England had among the worst death rates in Europe for lung conditions and that these conditions were a “main leading driver for hospital admissions and winter pressures”.
In addition, Ms Fisher said there was a “huge mortality gap between rich and poor”.
“So, there’s some really big reasons behind it,” said Ms Fisher, referring to why the champions pilot was launched.
She said a focus of many of the champions’ action plans was reducing the overprescribing of short-acting beta-2 agonists (SABAs) for people with asthma.
SABAs, such as salbutamol, are usually administered via blue reliever inhalers.
In recent years, new evidence and guidance have warned against the excessive use of SABAs, as it may mask the progression of a patient’s asthma and contribute to severe exacerbations.
Ms Fisher said the overprescribing of SABAs was “such a big issue in respiratory” and the charity therefore welcomed the champions’ work on it.
She added that she was “really pleased” that funding had been secured to extend the programme for another year as it provided longer to prove the sustainability of the champions’ projects.
“I think you certainly need more than a year to prove that such a brilliant, innovative programme works. So, it’s really great that they can carry on for another year,” said Ms Fisher.
In the longer term, the hope is that the programme can be made permanent and rolled out to the whole of the UK, Ms Fisher explained.
“We would like to extend it to all areas in England and also out to the health boards in the devolved nations,” she added.
“That would be our ultimate aim. That’s what we’ve always wanted to do, but it takes a bit of time.”
One of the nurse champions is Victoria Campbell, respiratory nurse consultant for Staffordshire and Stoke-on-Trent ICS.
Ms Campbell currently leads a community respiratory team for Midlands Partnership University NHS Foundation Trust, but also has previous experience in hospital respiratory services.
Victoria Campbell
She said she was keen to apply for the champions role when it came up because of lung health issues in her local population.
“Staffordshire has got a heritage and history of quite poor lung health, and I knew that we were an area of high concern because we’ve got high hospital admissions to do with asthma and COPD,” Ms Campbell told Nursing Times.
“I had got experience of working in the hospital prior to doing my current role, in respiratory as a respiratory specialist, and I thought, ‘Blimey, this is a really good opportunity for us to really focus a bit of a spotlight on Stoke-on-Trent and Staffordshire and use the expertise that Asthma + Lung UK have got’.”
The action plan that Ms Campbell has put together is multifaceted, but a key part of it is supporting primary care staff to move patients onto SABA-free treatment pathways.
She has been visiting primary care teams several times a month to deliver educational sessions on the new guidance related to SABAs.
In addition, Ms Campbell has worked with the medicines optimisation team lead for respiratory at her trust to put together a business case to provide primary care providers with external support from pharmacists to review patients’ treatment plans.
“That’s a really important opportunity, to be able to go and say, ‘Look, we’re going to give you some free time, you won’t need to do all this work yourself, we can employ somebody to come and do a week’s worth of work for you, to really break the back and get your patients uplifted onto a better treatment for them’.”
Another aspect of her action plan is around reviewing the respiratory care pathways in her area, particularly in relation to COPD, to make them more streamlined and connected, as well as improving access to respiratory care for people within prisons and mental health and learning disability services.
Ms Campbell said being part of the champions programme had not only given her dedicated time to focus on improving care, but had also helped boost her professional status and confidence.
She noted how, as part of her day job, she sat on various long-term condition boards and interest groups, which required her to interact and raise concerns with integrated care board and primary care network leaders.
Being able to use the champion badge had given her “a little bit more kudos, a little bit more of a brighter spotlight, that an external organisation recognised that I’ve got a skill set”, she explained.
“So actually, strangely, it’s almost given me a bit more of a loud voice within Staffordshire and Stoke-on-Trent so that I can be more of an advocate for people,” she told Nursing Times.
She added: “It’s given me that platform and that bit of extra confidence that actually, no, I am good enough to do this.
“Because probably speaking to nurses, a lot of nurses have a little bit of self doubt and don’t want to rock the boat too much. But actually, it’s given me a bit more permission to be a bit more noisy.”
As such, she urged other nurses to apply for similar opportunities when they arose and “believe that they can do it”.
