Welcome and introduction

1. Welcome and introduction Mo Akindolie, Clinical Director, CYP team, HLP Tracy Parr, Director of Transformation, HLP

2. Social media and housekeeping #AskAboutAsthma @HealthyLDN www.healthylondon.org WiFi: Coin Street Community Builders Password: 3vents2016 Download www.menti.com

3. Mentimeter • Who’s here today? • Please go to www.menti.com • Enter code: • What do you hope to get out of today's event? • Enter code:

6. https://media.giphy.com/media/CmBqRrbtYFtyU/giphy.gif

7. Five Year Forward View

8. Control F • 41 pages

10. NHS Long Term Plan

11. Control F

13. Asthma facts and recent publications • London Ambulance Service deal with 2 million 999 calls a year, 13,000 are from CYP with asthma and breathlessness • UK has the highest rate of deaths from asthma for young people aged 10-24, compared to all European countries (Nuffield Trust 2019) and they have risen by 33% in past decade in England and Wales (BMJ) • Over 1,400 people died of an asthma attack last year, up 8% from 2017 London experienced a 17% surge between 2017 and 2018 (ONS) • 90% of asthma deaths are preventable • Asthma-related GP appointments triple over the back-to-school period, • People from deprived communities are more likely to be exposed to asthma triggers, to be admitted to hospital for asthma and are less likely to manage their asthma well (AUK 2018) • 11 % of asthma cases could be prevented each year if countries adhered to the maximum air pollution levels recommended by the World Health Organisation (WHO) • (Barcelona Institute Global Health,2019)

14. London and National • London Vision • Refresh of Better Health for London Mayor launching October • 10 key areas including air quality and whole system networks

15. Air Quality: Partnership working • More than two million Londoners living in areas exceeding legal air limits – including 400,000 children • 9, 400 died in capital last year due to air pollution • Mayor has introduced ULEZ (Ultra Low emission zone) • Mayors fund £1.27m to create green spaces, community gardens and playground pollution barriers • 29 schools – restricting road use, upgrading boilers, tackling idling engines • Promoting walking and cycling • Plants and hedges • Air quality maps • Air Quality monitors including in school backpacks

16. Air Quality: Innovation Google street view cars monitoring air pollution Toxic Toby Bear

17. Asthma and allergy deaths in London Lines & Arrows Enfield Harrow Barnet  WalthamForest Haringey  Brent Hillingdon Redbridge  Islington Camden City & Hackney Havering Ealing Central London (Westminster) Newham Barking and Dagenham Tower Hamlets H&F West London (K&C &QPP) Hounslow  Southwark Lambeth Richmond Wandsworth  Greenwich  Lewisham Bexley Merton Kingston Key: STP area Sutton North East London STP Croydon Bromley North Central London STP North West London STP South West London STP South East London STP Death awaiting coroner’s report 

18. National Asthma deaths by age group England, between 2001 and 2017 33% rise during 2008-2018

19. London asthma data • One of top three causes of hospital admission for CYP • CYP with asthma action plan four times less likely to be admitted to hospital (Asthma UK) • Estimated that 75% admissions and 90% deaths preventable with optimal care • Annual cost unplanned admissions and PICU admissions £5.6 million across London • Investment in asthma reduces in-patient costs and improves self management, quality of life, reduces time off from school

20. London ambulance respiratory calls (2019) Source LAS Aug 2019

21. London ambulance data Source LAS data Duke Razon study 2019 UCL

22. London asthma QOF data prevalence 2017-18 National average: 5.93% London average: 4.25% Aiming for 10% but

23. London Programme: Transforming the pathway through Improved co-ordinated care ambitions and standards for asthma care in CYPSupport across the system to improve asthma care, reduce mortality, morbidity and admissions https://www.healthylondon.org/children-and-young-people/london-asthma-toolkit Ambitions Standards Online Asthma Toolkit “The London asthma standards for children and young people have been reviewed and published as a NICE Shared Learning example’.

24. Highlight the link between asthma and air quality at every opportunity, and direct attention to the Air Pollution Toolkit • Continue to work with GLA to ensure London Vision respiratory group recommendations are implemented effectively Air quality So what are we doing? Asthma work programme • Scope potential to scale interventions to reduce asthma deaths and improve outcomes • Take forward (with STP agreement) innovations including: • SWL emergency asthma bags and other school-centred work • Pharmacy initiatives • PCN multidisciplinary child hubs and other PCN resources • Group consultations • STP page on asthma toolkit • Update London asthma standards in line with national guidance and advice from Asthma Implementation Group • Potential for self-assessment by providers to determine progress • Align with national developments related to London Vision and LTP • Data collection, measurement plus access to correct data through toolkit • Scope potential for diagnostics for CYP in hubs (incl guidance TBC) Whole system improvement Scaling up/sharing innovation HLP provides support and expertise to aid network development. Networks = promotion of evidence-based practice and knowledge between individuals & organisations, engaging clinicians in improved models of care, improving integration & MDT working, improving pathways, referrals and cross-boundary working. All leading to improved quality of care and access for patients Asthma networks Link in to Primary Care Networks Link in to Severe Asthma Network • Complete the pilot of the DHP in NEL • Evaluation and further development: • Align with NHS Login • Explore interoperability with local clinical systems (NWL Information Exchange) • Expand app to parents, carers • Include allergy, diabetes and MH crisis self-management plans Digital Health Passport • Deliver pan-London awareness campaigns to coincide with Sept spike in admissions and throughout the year (World Asthma Day etc) • Evaluate and monitor impact • Focus on 3 simple changes that impact patient outcomes: • Personalised asthma plan • Checked inhaler technique • Annual asthma review • ‘One thing…’ focus in 2019 Comms and #AskAboutAsthma • Add and promote new content in line with key public health campaigns and seasonally relevant health topics • Support on-going adoption of NHSGo, securing 100,000 users by March 2020 • Include NHSGoin NHS App Store library • Explore development of NHSGo Local (CCG access to platform, TBC) and potential adoption by national team Improved self-care for CYP

25. Sweatcoin #AskAboutasthma campaign • Push notifications promoting: • Clean air routes • GP / Pharmacies - flu jabs and campaign • Social media promotion Promoting OneThingLDN 40% users 18 -24 Promoting NHS Go

26. Update • Clinical audit launched June 2019 • No of sites registered (as of 24 June) = 143/183 • Patient data entered onto web tool (as of 24 June) = 100 • Organisational audit dataset in development for planned launch of Dec 2019; • Run chart metrics/benchmarking in development;

27. Manager Clinician Student Innovator Financer Patients and Public Networks – benefits and why we are here today • What is a network? Improved clinical pathways Improve relationships Data sharing and best practice Share risk Learning and development Included in contract specification New ideas and perspectives Better outcomes