Significant COPD death rates fall in Northumbria

Dr Stephen Bourke, COPD and NIV clinical and research lead at Northumbria Healthcare NHS Foundation Trust. Picture by Simon Williams.
Dr Stephen Bourke, COPD and NIV clinical and research lead at Northumbria Healthcare NHS Foundation Trust. Picture by Simon Williams.

Work at the Northumbria Specialist Emergency Care Hospital is proving that direct admission under respiratory specialist care 24/7 can radically reduce chronic lung disease death rates, according to new research.

The study, which was presented at the British Thoracic Society Winter Meeting, showed a substantial fall in death rates of patients admitted with an acute deterioration of chronic obstructive pulmonary disease (COPD), both in hospital and 30 days after discharge.

Combining both periods, mortality fell from 18.1 per cent to 10.4 per cent for those who required ventilation, and from 6.2 per cent to 4.3 per cent for those who did not.

The specialist emergency care hospital near Cramlington, which opened in June 2015, has a respiratory support unit for non-invasive ventilation – airway support administered through a face mask – with enhanced staffing ratios and trained physiotherapists setting up all non-invasive ventilation (NIV), monitoring and weaning off.

Its other features include direct transfer from emergency department to speciality wards, 24/7 speciality consultant on-call and seven day consultant review.

The research was carried out by independent charity The Health Foundation in response to a National Confidential Enquiry into Patient Outcome and Death report about the UK in-hospital death rate for COPD patients who had an acute deterioration that required ventilation.

It analysed 6,291 COPD patients between 2013 and 2016, with comparisons made between before and after the specialist emergency hospital opened.

Dr Nicholas Lane, member of the British Thoracic Society and NIV outcomes research fellow at the trust, said: “This was not an overnight switch – these changes have taken place over time as we audit, re-audit and evaluate – but we can see them making a great difference.

“The main change has been providing access to a consultant specialist early in every hospital admission, rather than seeing a general consultant first.

“And investing strongly in technical and workforce respiratory support, with enhanced staffing and additional ventilators, has ensured that we always have capacity to offer this life saving treatment to patients who need it.”

Dr Stephen Bourke, COPD and NIV clinical and research lead at Northumbria, added: “These outcomes also reflect the dedication of the respiratory nursing and physiotherapy teams, with sustained quality improvement initiatives.”