Case-finding for COPD & Asthma

Wessex Academic Health Science Network, West Hampshire Clinical Commissioning Group (CCG) and CLAHRC Wessex (Collaboration for Leadership in Applied Health Research & Care) all succeeded in the earlier identification and diagnosis of Chronic Obstructive Pulmonary Disease (COPD) and asthma as a priority for Wessex. 

The purpose of this joint-working approach was to find the most effective method of identifying adult patients who had symptoms but were not yet diagnosed or had complicated/complex COPD or asthma. 

Case-finding Clinic

We will identify patients through a respiratory specialist nurse-led ‘case-finding’ clinic, where symptomatic patients without a diagnosis, are invited to attend a 60-minute appointment. Full diagnostic spirometry and a respiratory assessment are carried out at this clinic. The nurse then suggests a potential diagnosis and recommends further treatment or investigations to the GP where relevant, and also provides treatment, such as smoking cessation advice, where clinically appropriate.

Complex Clinic

This is a 60-minute appointment for patients with a diagnosis of COPD and/or asthma who are considered to be poorly controlled or at risk of deterioration. This includes:

• a 20-minute initial assessment by the respiratory nurse specialist
  
• a 20-minute assessment by a specialist respiratory physician (consultant respiratory physician or GP/academic with a special interest in respiratory), working alongside the clinical practice staff
  
• a 20-minute follow up education session with the respiratory nurse specialist.