Enhanced Integrated Respiratory MDT

Implementing an Enhanced Integrated Respiratory MDT with Boehringer Ingelheim Joint Working Project Executive Summary

Identification and optimisation of care for patients at risk of respiratory admission through an enhanced integrated multi-disciplinary team

A joint working project between Boehringer Ingelheim Ltd (BIL) and Oxfordshire Clinical Commissioning Group (OCCG).

Long term conditions (LTCs) are a significant burden to the NHS, with over 15 million people affected in England, consuming over 70% of primary and secondary care budgets.  Chronic obstructive pulmonary disease (COPD) is a long term condition and the second most common lung disease in the UK, affecting 1.2 million people.  The annual direct care costs of COPD in England are £1.5bn, a significant burden to the NHS.  COPD is the second most common cause of emergency admission to hospital and one of the most costly inpatient conditions to be treated by the NHS.  Oxfordshire Clinical Commissioning Group and Boehringer Ingelheim have designed this joint working project to run across the North and City localities of Oxfordshire with the aim of improving outcomes and experience of care for respiratory patients.  Following development of the Project Initiation Document the project was approved by the Board in September 2018 as detailed in the Board paper.

For more information see the Department of Health and the Association of the British Pharmaceutical Industry Joint Working toolkit .

The project seeks to improve a number of patient outcome measures by coordinating service provision around the needs of patients by forming a multi-disciplinary integrated respiratory team (IRT).  This aims to enhance existing community and hospital based teams by increasing consultant, nursing and physiotherapist resource and integrating with specialist GPs, a psychologist, a pharmacist, dedicated smoking-free advisor and specialist palliative care support.

The IRT will take a person centred approach as defined by National Voices Narrative for Person-Centred Care as follows: ‘I can plan my care with people who work together to understand me and my carer(s), allow me the control and bring together service to achieve the outcomes important to me’.

This pilot aims to provide more timely and coordinated care closer to home for patients.  This proactive and preventative approach aims to reduce system costs by reducing emergency department attendances, non-elective admissions and re-admissions.  The pilot will start in November 2018 and run for 15 months and inform future commissioning of services across Oxfordshire.

Boehringer Ingelheim is pleased to collaborate with the NHS across Oxfordshire and explore the challenges and support needed to implement an integrated multi-disciplinary care pathway.  Learning from the project will be shared with the wider healthcare community to further support improvements in patient care.

The evaluation report and appendices are available in the Related Downloads section below.


For further information contact Paul Swan