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Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.

Contact Information:

Prof Alice Turner
+44 (0)1213713885
a.m.turner@bham.ac.uk


Dr Lucy Boast
+44 (0)1213713886
l.a.boast@bham.ac.uk


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Be Part of Research - Trial Details - Optimising respiratory integrated care services
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Optimising respiratory integrated care services

Recruiting

Open to: All Genders

Age: Adult

Birmingham

Medical Conditions

Chronic respiratory disease: asthma, bronchiectasis, interstitial lung disease, sleep apnoea

This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.


NHS England has identified respiratory care as one of five clinical areas in which there are substantial health inequalities that may disproportionately affect those in the most deprived 20% of the population and/or those from ethnic minority communities or with other protected characteristics (CORE20PLUS5). Addressing these inequalities is an NHS England priority, with integrated respiratory care proposed as a key means of optimising service organisation and delivery. Integrated respiratory care aims to be patient-centred, delivering care that is seamless, proactive and coordinated through clinical leadership and the multi-professional team working together across organisations, healthcare settings and pathways. Local data demonstrate that Birmingham and Solihull Integrated Care Board (BSol ICB) has the highest COPD admission rate of all ICBs in England at nearly 50% above the national average.
Whilst evidence suggests that integrated respiratory care can effectively manage patients with a range of chronic respiratory conditions, the optimal configuration of such services remains unknown. It is also important that integrating respiratory services by providing specialist-led care does not have unintended consequences. For example, the INTEGR COPD study (2017 to 2019) showed the unexpected finding that significantly more patients were admitted to hospital with respiratory illness in the intervention group vs control. Objective 2 within the proposed study seeks to determine the reasons for this through case review. Given current plans to expand the integrated respiratory service more widely across BSoL ICB, alongside the introduction of COPD risk stratification to identify patients at highest risk of COPD exacerbation, there is a need to understand factors that may affect implementation of integrated respiratory care through additional qualitative work with patients and healthcare professionals (objectives 3 and 4).
By evaluating integrated approaches to provide access to specialist input for patients with common chronic respiratory conditions and to identify those most at risk of deterioration and/or acute hospitalisations, this project aims to draw practical conclusions regarding the factors involved the design and delivery of an optimal integrated respiratory service in a deprived urban area.
This study aims to determine the optimal service configuration for an integrated respiratory service in a deprived urban area.
Study objectives:
1. To systematically review the literature on integrated respiratory care to understand which service models have been used to manage chronic respiratory conditions nationally and internationally.
2. To understand whether there is an association between the integration of respiratory clinicians into primary care reviews and the risk of hospitalisation in COPD.
3. To gather learning locally and from other sites within the UK that have used integrated care approaches for respiratory conditions, using qualitative interviews with clinicians to identify best practice.
4. To understand the impact of service changes to expand integrated respiratory services on healthcare staff and patients.

Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.  

The recruitment start and end dates are as follows:

10 Feb 2025 01 Oct 2025

The study will comprise four objectives:
Objective 1 involves a systematic review of the literature focusing on models of integrated care for respiratory conditions.
Objective 2 will comprise a further evaluation of data on patient hospital admissions collected in the INTEGR COPD study. A case review of each hospital admission recorded during that study (n = 347) will be undertaken to understand whether there is an association between the integration of respiratory clinicians into primary care reviews and the risk of hospitalisation in COPD.
Qualitative interviews from up to 25 clinicians working within or leading integrated respiratory services locally (n = 10-15) and nationally (n = 5-10) will be undertaken to understand the factors involved in designing and delivering respiratory integrated care services and to identify best practice. A survey will be distributed to respiratory medicine trainees.
An embedded service evaluation in objective 4 will comprise an analysis of routinely collected data on the impact of using different risk stratification approaches for patients with Chronic Obstructive Pulmonary Disease will be undertaken by the Midlands and Lancashire Commissioning Support Unit. Interviews with up to 10 healthcare professionals involved in delivering integrated services within BSol ICB, and up to 10 patients who received integrated respiratory care will be undertaken.
Interviews will last for up to 60 minutes, and surveys will take around 10 minutes to complete.


Healthcare professionals or trainees working in the NHS in England, whose role includes providing care and support to people with chronic respiratory disease will be eligible to take part in a qualitative interview (objective 3 will be open to professionals from across the UK, objective 4 will be restricted to those working within the Birmingham and Solihull Integrated Care Board region). UK respiratory medicine trainees will be able to participate in a trainee survey.
Patients with a chronic respiratory disease who have been seen within the respiratory integrated care service in Birmingham and Solihull within the last 12 months will be eligible to take part in a qualitative interview (objective 4).

You can take part if:



You may not be able to take part if:


Objective 3:1. Not a member of clinical or operational staff in an integrated respiratory service within the last 12 months2. Not involved in organisation/delivery/commissioning of integrated respiratory services within the last 12 months3. Unable to consent

Objective 4:1. Healthcare Professional - Not a member of BSol ICB catchment area services2. Patient – not reviewed by the BSol ICB integrated respiratory service 3. Unable to consent


Below are the locations for where you can take part in the trial. Please note that not all sites may be open.

  • University Hospitals Birmingham NHS Foundation Trust
    Queen Elizabeth Hospital Mindelsohn Way Edgbaston
    Birmingham
    B15 2GW

There will be no direct benefits to the research participants by taking part in this research, however, patients may find some satisfaction in helping researchers work towards improving integrated respiratory services for others with similar health conditions. Clinical staff participants may feel more engaged and valued in their workplace through the ability to contribute their views to the understanding and planning of the services in their locality.
It is possible that participants will be inconvenienced by completing a survey or taking part in an interview. Surveys can be completed in as many sessions as participants may require, with electronic versions allowing saving or partial responses for later completion. Interviews will be arranged at a time and via a format that is most convenient for participants.
There are no risks for patients whose historical hospital admission episode(s) will be assessed using case review (objective 2). Case note review focuses purely on data collected as part of usual care during the hospitalisation episodes and will not affect any care patients received at the original time of the study or currently.

Dr Lucy Boast
+44 (0)1213713886
l.a.boast@bham.ac.uk


Prof Alice Turner
+44 (0)1213713885
a.m.turner@bham.ac.uk



The study is sponsored by University of Birmingham and funded by National Institute for Health Research Applied Research Collaboration West Midlands.



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Read full details for Trial ID: ISRCTN10288093
Last updated 10 February 2025

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