Chronic Obstructive Pulmonary Disease (health and wellbeing needs in South Tyneside)

In order to engage with key stakeholders and patients in relation to the local COPD pathway, the Respiratory Strategy Group used the socio-technical allocation of resources (STAR) approach.[1] STAR is intended to be one method for understanding where to prioritise resources and needs to be used in conjunction with other tools and approaches. It provides a wide stakeholder group with a collective understanding of the issues around resource allocation for a specific service or condition.

A diverse range of stakeholders were involved in the process, from the local council, acute trust, community services, pharmacy services, the local health commissioner, and patients and carers.

The findings are:

• The approach highlighted that a large part of respiratory spend goes toward high-cost low-benefit interventions such as inhalers and emergency admissions - some of which are potentially avoidable.
• In contrast, high-benefit interventions such as smoking cessation and pulmonary rehabilitation receive little funding with low numbers passing through these services.
• Reinforced the message that effective smoking cessation is by far the most effective intervention to prevent worsening of COPD and improve quality of life and life expectancy.
• The benefit from inhalers could be dramatically increased and costs reduced by improving inhaler technique, also reducing the need to step up treatment and prevent exacerbations.
• A very strong case was made for commissioning Cognitive Behaviour Therapy (CBT) in the COPD pathway, which supports previous iterations of Star application to COPD.