Asthma Winter Readiness Pilot Project

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        "title": "Asthma Winter Readiness Pilot Project",
        "description": "Asthma Winter Readiness Pilot Project drives forward the previous EMBRACE (Empowering Medical Best Practice Reviews Assuring Clinical Excellence) Severe Asthma project. The aim of the project is to identify patients through risk stratification and predominantly digital review, those patients who have both the greatest potential for improvement in treatment and being at significant risk of further complication and acute hospital admissions. The Project has been endorsed by the East England. The Norfolk and Waveney ICB (NWICB) Sponsorship and Joint Working Committee has also approved the project. Stage 1 - Practice engagement and Data Sharing Agreements Norfolk and Waveney ICB will contact each GP practice to advise of the locally commissioned Asthma winter readiness service being delivered in the ICS. GP surgeries (acting as Data controllers) must opt-in to participate in the service. It will be made clear to practices that opting into the project will mean a summary level anonymised outcome report will be shared with Norfolk and Waveney ICB. To participate, GP practices must complete an automated proforma (supplied by provider) for acceptance of the project and explicit consent for patient engagement. The project will be completed where appropriate under existing Data Sharing Agreements (DSA), where a DSA is not in place and practices would like to participate in the project, the provider will engage with practices to ensure a DSA is completed. Stage 2 - Patient identification The provider will run a bespoke search of the GP practice anonymised database; this will identify those patients eligible for the service (outlined in section 3.3). Patients identified as eligible for the asthma service (now de-anonymised) in the highest risk groups will be flagged to each participating GP practice with a request for the provider to engage directly with those patients. GP practices will at this point agree which patients will be invited for review.",
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        "procurementMethodRationale": "The project can only be delivered through utilisation of Eclipse software provided by Prescribing Services Ltd. The software is a proven product and supports Norfolk and Waveney ICB Population Health. Funding for Asthma Winter Readiness project has been approved by Triple Lock Reference ICB-NP347 The Asthma Winter Readiness project is a collaborative, quality improvement programme. Implemented at an ICB level aimed at providing additional resources into primary care to accelerated timely and equitable access for patients with moderate to severe Asthma to appropriate care and treatment, by deploying a digitally enabled, pathway to proactively identify, risk-stratify, and triage patients to appropriate care at the population level without additional primary care capacity requirements. Early intervention and improving the treatment of people is part of ICB's Prevention Programme. This project seeks to utilise public health management data, mitigate health inequalities and improve accessibility through risk stratification and review utlising digital technology, of patients with moderate to severe Asthma, who would benefit from care planning and optimal guideline driven medication therapy. Severe asthma is a debilitating form of asthma affecting ~4% of patients with asthma. These patients have on average 4 asthma attacks/year, 4x more hospitalisations vs patients with asthma, and often exposed to high levels of oral steroids, with significant short- and long-term side effects. Patients with severe disease account for ~50% of all asthma related healthcare costs. Norfolk & Waveney: 7.6% registered asthma patients (England 6.5%); Adult emergency hospital admission rate (England 44.4) Mortality rate for asthma (3-year range) 2.74 (England 2.36)",
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