A Joint Working Case Study Stockport Clinical Commissioning Group (CCG) and Teva UK Limited
This is a case study of how Stockport CCG participated in a local joint working initiative with the Project Group from Teva UK Limited to explore how cascading advanced knowledge of inhaler technique to healthcare professionals (HCPs) could help patients recognise their type of inhaler device and associated technique.
Asthma and COPD are long term conditions that feature prominently in Domain 2 of the NHS Outcomes Framework 2013/2014 and National COPD and Asthma Outcomes Strategy, Department of Health.
Research has shown that:
It has been demonstrated in several areas of the UK that engaging patients that use inhalers in Medicines Use Reviews and providing HCPs with the right skills and tools to deliver these can lead to an improvement in outcomes for patients.
Whilst prescribing might be optimal, if a patient cannot use their inhaler properly, there is a risk that their lack of control will result in further treatment interventions, such as unnecessarily high inhaled corticosteroid (ICS) doses. Patients with poor control of their asthma and COPD are more likely to have exacerbations and be admitted to hospital as a consequence.
The cost of medicines waste resulting from suboptimal inhaler use is considerable. Poor control may lead to extra cost with regard to GP and nurse appointments and hospital admissions.
For these reasons Stockport CCG identified inhaler technique as an area of focus in 2014 and 2015. A part of this focus stated a desire to leave a legacy of improved knowledge relating to Inhaler Technique across general practice in Stockport CCG and cascade this knowledge to patients via primary care healthcare professionals.
Recognising this opportunity, the objectives of this joint working initiative in Stockport CCG were to:
The joint working group was interested to see if and how this approach could reduce and prevent emergency hospital admissions amongst asthma and COPD patients.
The success of the project in meeting the desired outcomes was measured in the following ways:
In order to achieve these outcomes, Stockport CCG worked in collaboration with Teva UK Limited as they provided:
Both Stockport CCG and Teva UK Limited abided by the relevant regulatory bodies and guidance, including the ABPI Code of Practice.3
The project was split into three distinct phases.
The project succeeded in improving respiratory care by raising the importance of inhaler device technique in a consistent and informed way with healthcare professionals and patients.
Prior to the HCP inhaler technique training:
45 healthcare professionals were trained. After attending the HCP training on inhaler technique, the following percentage of healthcare professionals felt the following:
11 patients reported back on the training. After receiving training from an HCP on inhaler technique as part of the project:
The aim of recruiting more than 25 practices for the project was missed, with only 6 practices being recruited for reasons outside the scope of this project. However, those 6 practices were able to demonstrate patient outcomes.
This project demonstrated a successful collaborative approach to address a significant issue facing the local health economy.
The project improved respiratory care through improving the knowledge of healthcare professionals in relation to the types of inhaler devices available and the associated inhaler technique.
This improved the skills of the healthcare professionals so that they are able to support patients suffering with asthma.
Joint working between Teva UK Limited and the NHS must be for the benefit of patients or the NHS and preserve patient care3