Mobile Respiratory Clinic
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Respiratory health remains a real burden to the NHS (National Health Service) in Wales, with 1 in 12 people having a respiratory illness. Wales also has the highest prevalence of asthma in Europe, meaning that the rate of respiratory patients in Wales is higher than average. One impact of COVID-19 is a significant reduction in the number of patients being seen, and diagnostic procedures carried out. As the NHS begins to reopen non-COVID services, it faces a huge backlog of unmet patient need, with patients facing long waits for treatment. Due to COVID, staff are working overtime shifts at reduced capacity, to meet clinical demand, which is approaching unsustainable levels Respiratory Innovation Wales, in collaboration with CTMUHB (Cwm Taf Morgannwg University Health Board), HDUHB (Hywel Dda University Health Board) and industry partner EMS, developed a mobile unit solution to address the shortfall within community services. This provides increased access to respiratory diagnostics, intervention, and throughput of testing by providing a low-risk environment (utilising 30-minute PCR testing of staff and patients as a screening precaution). In a mobile unit, which can be parked in places convenient to the patient. For example, supermarket car parks etc.
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- Cwm Taf Morgannwg University Health Board
- Hywel Dda University Health Board
January - April 2022
Programme planning by RIW
6th May 2022
Bus commissioned and tested for safety etc
12th May 2022
First patient HDUHB
19th May 2022
First patient CTUHB
10th November 2022
1064 patients seen
10th November 2022
Cluster funding £240K secured from HDUHB for another 4 months
November - December 2022
PREMs and PROMS gathering an analysis
November 2022 - January 2023
Value-based estimates started
February - March 2023
Report to Welsh Government and Health Boards
The project aims to provide significant cost efficiencies, with an expected reduction in provisioning costs by a minimum of £2,873,700 by relocating primary and community respiratory services back to a community-based environment for a cost of £300,000. Other aims include:
- Develop an immediately deliverable, 6-month mobile service set in a primary and community context to deliver respiratory diagnostics and intervention
- To embed technical innovation into the service to create pre-COVID levels of patient flow on the unit and to provide standard diagnostic and interventional services and to explore, implement and evaluate advances in diagnostics
- Provision of services at comparable and potentially enhanced efficiency and shorter patient pathways to pre-COVID patient flow rates
- To decentralise care, bringing care closer to the patient.
- To evaluate outputs and outcomes using a values-based healthcare approach and involving the collection of PROM’s (Patient Reported Outcome Measures) and PREM’s (Patient Reported Experience Measures) data
To provide a model for mobile services that can be rolled out on an all-Wales Basis
Desired outcomes
- Reduce respiratory diagnostic testing backlog.
- Reduce risk of burn out and staff retention in specialist health board clinicians.
- Provision of a reduced risk managed service to health boards
- 6 Month delivery of community respiratory diagnostic services
- Increased patient testing rates
- Reduction in waiting lists
- Reduction in predicted acute hospital site attendance and referrals
- Minimal risk testing environment for at risk patients
Sustainable model evaluated for scalable provision of decentralised services with other modalities facing similar difficulties.