Asthma Winter Readiness Pilot Project

Asthma Winter Readiness Pilot Project drives forward the previous EMBRACE (Empowering Medical Best Practice Reviews Assuring Clinical Excellence) Severe Asthma project, following the withdrawal of Astra Zenica. 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. Stage 3 - Patient Engagement The provider will engage with the individual patients. Patients indicating their desire to participate in the asthma winter readiness service, will give their consent to be contacted by the provider. As part of the patient consent process, patients will be asked to complete an online digital patient questionnaire. Patients identified as having missing data or non-responders will also be contacted for targeted sign up and support to complete the online survey. Stage 4 - Patient stratification Once all required information is gathered, patients will automatically enter a risk stratification AI algorithm, pre-agreed by the Project Group, with defined parameters to triage patients based on their risk of future events. Patients will be stratified into high (red), medium (amber) and low (green) risk groups as outlined in section 3.2. Stage 5 - Patient review The provider, using baseline health data provided by ECLIPSE and supplementary information provided by the patient, will contact the patients and run a comprehensive review and education service. Patients risk stratified into high (red) will be assessed whether suitable for potentiual biologic therapy. Specialised care and treatment for severe asthma can improve outcomes for patients; specifically, NICE approved biological therapies as add-on treatments for patients with severe uncontrolled asthma are therapeutic advancements that have demonstrated clinical improvements in patient outcomes, including exacerbation reduction, OCS reduction, improved lung function and improved quality of life. There has been a clear mandate from the NHS to improve access to severe asthma care and treatment for patients with severe uncontrolled asthma. The Accelerated Access Collaborative has embarked on the rapid uptake programme, specifically focused on improving access to medicines.