Breakout 3.2 National Survey of Multi-morbidity in clinical practice with COPD as an examplar - Dr Shoba Poduval Clinical Support Fellow and First5 GP Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013, Guoman Tower Hotel, London How to deliver quality and value in chronic care:sharing the learning from the respiratory programme

1. National Survey of Multi-morbidity
in clinical practice with COPD as an
examplar
Dr Shoba Poduval
Clinical Support Fellow and First5 GP
Survey
• 7 point questionnaire uploaded to survey
monkey
– What did you do? How did you do it? Why? What
prompted you?
– Overall impact -how this benefits patients, staff
and the organisation
– Lessons learnt, what went well? What didn’t
work well? Advice for others
1

2. Survey
• Open 29.11.12 - 8.2.13
• Thirty four responses
• Thirteen reviewed- themes
• Five case studies
• Other Practices of note- telehealth
Preliminary Results
Themes • Outcomes
• Motive • Evaluation
• Patient selection & • Challenges
invitation
• Organisation
• Staff
• Housebound patients
2

3. Motives
• QoF
• PBC/CCG funding
• Improving patient experience
Patient selection & invitation
• Disease registers
• Disease severity stratification
• Specific patient selection criteria
3

4. Staff
• Practice team: GP’s, Nurses, HCA’s, admin staff
• Community team: District Nurses, Community
Nurses, Social Services, Pharmacists
• Secondary Care
Housebound
• Visits by GP’s & Community Matrons
• On-going support from Community Matron &
Social Services
4

5. Outcomes
• Patient and staff satisfaction
• More appointment time available
• Medication adherence
• Reduced A&E attendance
• Projected savings
Challenges
• Training
• Organisation- time
• Resources- templates
• Funding
5

6. Discussion
• What is your experience of managing
multimorbidity?
• Challenges?
• Suggestions?
6