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In the UK 70,000 people are living with pulmonary fibrosis. We support those affected, raise awareness and fund research to find a cure.
Top tips for ILD healthcare professionals on how to improve the efficiency of their services and see more patients.
Dr Lisa Spencer, a consultant respiratory physician who leads the Liverpool Interstitial Lung Disease (ILD) service, shares her valuable insights on how to manage rising referral rates and the demand for antifibrotic drugs.
How to improve your ILD service now: quick wins
Streamline your systems
Virtual MDT before seeing patients in clinic
You may be able to save time and make things easier for patients if you do a virtual MDT review of cases before you see the patient in the clinic.
This way, you may be able to deliver your patient’s first visit as a ‘one-stop shop’ with diagnosis and treatment decided on the same day.
This can reduce the wait for the patients to start drug therapy.
Offer multiple clinics on the same day where possible
Do ILD nurses or pharmacists run clinics alongside you? Could you offer nurse appointments or antifibrotic/immunosuppressant counselling on the same day?
This can further help to reduce delays to patients starting treatments or accessing support. It can also help to achieve many NICE ILD standards of care in one go.
Work closely with regional ILD networks
Are there hospitals in your network that can help follow up with some patient groups? For example, can idiopathic pulmonary fibrosis (IPF) patients on antifibrotic therapy be reviewed in local doctor clinics with support from your centre?
This could free up your capacity and provide patients with care closer to home.
Request time within your job plan
If you are the lead for your specialised ILD service do you have time in your job plan to lead your service? If not, can you negotiate with your clinical director? Depending on service size, this may need to be a PA per week. This will give you time to assess your service more deeply and optimise its efficiency.
Share patient care with referring centres in regional networks
Encourage staffing
Encourage local leads for ILD patients to increase staff where they can and appoint local respiratory nurses with ILD expertise to deliver local drug monitoring with support.
Offer education and support
This could include:
- ILD education talks
- Written plans
- Share your standard operating procedures
- Monthly support meetings from your nursing teams to theirs, to provide ongoing input for local patient care
- Consultants making themselves available for ongoing advice
Make it easy to contact you
Many teams are keen to be more involved with their patients as long as they know they can get unconditional and speedy support if they need it.
Is it easy for referrers to get in touch with your consultants and ILD nurses if they need to? Make sure they have your phone numbers and email addresses.
Share ideas regularly
Organise network meetings to develop closer working relationships with your referring centres. Share ideas on how to improve patient pathways and facilitate care closer to home where possible whilst maintaining standards.
How to improve your ILD service in the future: longer-term wins
If you're receiving more referrals than your service has the capacity for, you need to have data to evidence this and make changes. Consider:
- How many new referrals do you receive per year?
- How many ILD consultant clinic slots do you have?
- What is the deficit and how many consultant PAs do you need to bridge that gap?
- How many full-time equivalent band 6&7 nurses or above do you have per new patient referral?
- How many patients are they monitoring?
- How many can they safely monitor- what is the deficit?
- How do your numbers compare to services elsewhere?
Good luck!
Dr Lisa Spencer MBE is a Consultant Lung Specialist and leads the Regional Liverpool Interstitial Lung Disease (ILD) Service. She has extensive experience as a clinical trials investigator leading more than 30 studies over the last 20 years. She was a recent trustee and Honorary Secretary of the British Thoracic Society (2019- 2022) and is a current member of the Clinical Reference Group (CRG) for Specialised Respiratory Services for NHS England, representing ILD nationally (a commissioning committee). She was a previous Chair of The British Thoracic Society national ILD Registry programme. She was awarded an MBE in the Queen's Honours Birthday List 2021 for services to the NHS.