Despite having some of the poorest air quality in the country, London consistently remains below the national average for diagnoses of COPD and asthma, with severely reduced capacity for diagnosis due to the pandemic.
At Imperial College Health Partners, we worked with NWL Integrated Care System (ICS) to develop and implement a Respiratory Diagnostic Hublet (RDH) model: a dedicated service to provide access to quality assured spirometry and Fractional Exhaled Nitric Oxide (FeNo) to support accurate diagnosis of COPD and/or asthma at a population level, in a community setting.
We centrally coordinated a system-level steering group (with local and regional representation including ICS, primary and secondary care colleagues) who guided the execution of local delivery for this work.
Successful implementation of this project involved a number of stages, from developing service specifications to pathway mapping, to curating a suite of patient and clinician-facing communication resources and designing data templates to ensure adequate data flow across clinical systems, alongside clinical experts and technical teams.
Our outcomes for NWL:
More testing
Our primary care-based community model, delivered in line with regional guidance on the development of Respiratory Spoke Services from the London Respiratory Clinical Network, provided quality-assured spirometry and FeNO testing across all eight boroughs in NWL.
More collaboration
Our work facilitated integrated working between the specialist respiratory teams delivering the service in the community, and the respiratory consultants supporting the Respiratory Diagnostic Hublet.
Lasting change
The impact of this is a truly integrated approach to the transformation of out-of-hospital care, which brings acute and community teams even closer together, and relieves local hospital and GP pressures.
Explore our RDH resources
