What is a Service Framework?

1. Respiratory Service FrameworkAsthma and COPD Care (Nursing) Project Learning and Development Strategy

2. What is a Service Framework? Service frameworksare defined as being measurable, evidence–based standards which are the product of a process of engagement with HSC staff, service users and the public. Each Framework will follow the individual’s journey, from prevention through to end-of-life care, taking account of all aspects of health and social care providing an opportunity to promote evidence-informed practice with a focus on safe and effective care. Template for the Development of Service Frameworks for Health and Social Care Department of Health, Social Services and Public Safety, 2007.

3. What is a Service Framework? • Explicit standards on prevention, treatment and care • “Quality requirements” supporting the standards • Specific timeframe - 3-5 years and revision process • Capable of measurement/comparative data • Linked to the HSC quality standards and other policy, documents and guidance • Applicable to both adults and children • Follow a life cycle approach • Developed in collaboration with the HSC and public.

4. Patient/client Pathway Template Prevention / Promotion Protection /Lifestyle Assessment & Diagnosis Treatment Ongoing Care / Chronic Disease Management End of Life Care / Palliative Care

6. How will they be assessed? • Service Audits • Patient Registers • QOF data sets • DES data sets • PAS • Evidence collected by organisations to support achievement

7. Current Work April 2008 Cardiovascular Disease Respiratory Wellbeing Cancer Mental Health Learning Disability May/ June 2008 July 2008

8. The Future of COPD Nursing Care The RSF Standards

9. Communication Patient Education Multidisciplinary Working Location of Care Health Technology

10. Nurses Taking the Lead

11. Prevention / Promotion Protection /Lifestyle Modifiable Risks Smoking Cessation/ Prevention – Specific Targets Smoking Reduction Lifestyle assessment Physical Activity Planned Programmes Education – Medication compliance and efficacy Patient Partnership Negotiating a plan of care and lifestyle adjustments

12. Assessment & Diagnosis History Taking Airflow Limitation – SPIROMETRY Accurate, interpreted Screening – Symptomatic smokers Registers

13. Treatment Self Management – Face-to-face care planning Written copy One core written plan Acute Exacerbation – Early Supported Discharge Resp. Physician Emergency Oxygen – Alert cards BTS Guidelines NIV – Management of NIV Case Management – Expertise in Co-morbidities

14. Ongoing Care / Chronic Disease Management Telemonitoring – 50k patients in next 3 years Pulmonary Rehabilitation – MRC 3+ offered referral Monitoring uptake Programme Development and access Nebuliser Therapy – Assessment for Equipment – Compressor/ O2 LTOT – Adherence to Assessment Criteria Ongoing Monitoring – Annual Review/ ½ yearly Case Management

15. End of Life Care / Palliative Care Key Worker – Core Palliative Care Competencies Early Needs Assessment – MRC 5 Trigger Questions Patient Choice Supportive and Palliative Care Register Breaking Bad News - Communication

16. The Future of Asthma Nursing Care The RSF Standards

17. Communication Patient Education Multidisciplinary Working Location of Care Health Technology

18. Nurses Taking the Lead

19. Prevention / Promotion Protection /Lifestyle Modifiable Risks Smoking Cessation/ Prevention – Specific Targets Maternal Health/ Parental Health Lifestyle assessment – Allergy Triggers Physical Activity Education - Medication compliance and efficacy Patient Partnership Health Inequalities – Immigrant Populations Electoral Wards

20. Assessment & Diagnosis History Taking - One airway (allergic Rhinitis) allergy testing Diagnostic Therapy Trial Airflow Limitation – SPIROMETRY Accurate, interpreted

21. Treatment Self management– Face-to-face care planning Written copy One core written plan Anaphylaxis Management – Register Allergy expertise Acute Exacerbation – Treatment as per Guidelines Review and Follow-up – Admission A&E Non-admission

22. Ongoing Care / Chronic Disease Management Review – Frequent admissions Early Follow up Appropriate Referral – Difficult to Control Asthma Alert Cards – Education Inhaler Technique Allergy History - Testing

23. Thank you