Improving outcomes for patients with respiratory diseases was a priority highlighted in the NHS Long Term Plan.

Each year a small number of NICE approved innovative medical devices, diagnostics, digital devices or medicines are selected as rapid uptake products by the Accelerated Access Collaborative for coordinated spread across Academic Health Science Networks (AHSNs).

EMAHSN supported the spread and adoption of Asthma Biologics from October 2021.

Solutions / actions taken

Over 18 months, we supported primary care, NHS hospitals, ICBs and other organisations in the implementation of new and improved ways for the identification and review of patients that could benefit from Asthma Biologics.

This has included working together on:

• the use of identification and prioritisation tools
• development of pathways and patient information materials
• upskilling and educating healthcare staff about severe asthma

We supported local initiatives and ICB wide discussions and participated in national and region-wide forums, which supported the dissemination of learning and ideas from experts and the experience of other regions and organisations.

We also supported a Pathway Funded Transformation (PTF) Project at Nottingham University Hospitals NHS Trust and a local project at University Hospitals Leicester which focussed on implementing a Severe Asthma Pathway and Biologic Decision dashboard.

Key lessons learned

•  Consider how impact will be measured from the start: When teams are embarking on a new programme that could potentially make a significant difference to their patients, and time is short due to service pressures, it can be tempting to go straight into implementation.
  
  Spending time at the start to map potential benefits and how these will be measured is time well spent. Knowing the starting point and how pathway and/or service changes have made a difference will demonstrate success and give you the information needed to inform the next steps.
  
  Our Analytics and Evaluation Service can advise on ways to capture benefits and outcomes and different sources of data.

• Working together: The success of the Pathway Transformation Fund (PTF) project benefitted from primary care involvement and engagement. It was a real asset to have engaged and enthusiastic GPs, community nurses and managers contributing to the project from the start.
  
  This reinforced the importance of considering who needs to be involved from across the health and care system, early in the project planning.
  
  Seeking early collaboration and expertise from partners across the health and care system improves the effectiveness and efficiency of projects.

Impacts and outcomes from the project

This work has positively impacted the outcomes of many patients within the East Midlands region.

Many more patients can now access these innovative treatments in the region (60% more patients are now approved for Asthma Biologics) and a wide proportion of them are able to self-administrate the medication (42% of patients being treated with Asthma Biologics do so at home).

Several healthcare professionals have participated in educational events to learn more about severe asthma and how to treat it. In addition, a significant number of GP practices are using clinical audit tools that enable very effective identification and prioritisation of patients that suffer from severe asthma and could benefit from these innovative therapies.

Finally, national data is showing that the number of patients needing oral steroids to manage their asthma is decreasing and with this, the side effects associated with this type of treatment.

A summary of the impacts are shown below:

Resources

Oxford AHSN were the national lead for this programme and has developed a number of resources to support the implementation or improvement of practices and pathways. View the resources here.