Tag: pathway

Award-winning Long Covid support service extended

An innovative project to provide much-needed support to Long Covid patients has been extended to Midlothian.

Chest Heart & Stroke Scotland has worked with NHS Lothian, Pogo Digital Healthcare, patients and GPs to develop the individualised and easy-to-use Long Covid Pathway.

The pathway was piloted in Edinburgh in 2022, involving 36 GP practices and 173 patients, with plans to roll out across Edinburgh and the Lothians by the end of 2023.

GPs can refer patients directly into the pathway, which provides people with bespoke digital advice and also connects them to a CHSS nurse-led helpline and peer support.

The digital aspect of the service, the award-winning ‘MyTailoredTalks’, helps people manage their condition day-to-day while providing feedback to their GP to help with ongoing care.

Jane-Claire Judson, Chief Executive of Chest, Heart & Stroke Scotland, commented: “In Scotland, 94,000 people have been living with Long Covid for over a year. We know that people living with the condition feel scared, abandoned and left behind.

“Our Long Covid Support Pathway allows us to better support people living with the condition in Edinburgh and Lothian. Its success means we hope to see it rolled out across the country, helping more people with Long Covid to live their lives to the full.”

Professor Tim Walsh, Director of Innovation for NHS Lothian, said: “It’s been really important for us to bring together expertise from a range of organisations to better improve the support available for people with Long Covid.

“We know living with this can be really challenging and patients with Long Covid need support that can be individualised and available on demand, and we’re proud to have worked with our partners to have developed such support in Lothian.”

The Midlothian Health & Social Care Partnership Long Covid Project Team has welcomed the roll-out.. A spokesperson commented: “During the pilot phase, this pathway empowered people to make a successful transition after diagnosis towards self-management of Long Covid through effective and targeted self-management resources.

“GP practitioners in Midlothian are looking forward to utilising the pathway, which will remove travel barriers while still providing person-centered support and reducing demand on services. The combination of written, video and telephone support will provide people in Midlothian access to the most appropriate support for them.

“Importantly, support and self-management resources provided by MyTailoredTalks and CHSS are fed back to the referring GP without them needing to seek out this information. The pathway will enable people in Midlothian living with Long Covid to self-manage their symptoms and access up-to-date and validated information relevant to their needs.”

None of this would have been possible without NHS Lothian Charity, which has invested £120,000 in the platform so far.

Jane Ferguson, Director of NHS Lothian Charity, said: “As the official charity of NHS Lothian, we have a key role to play in supporting NHS Lothian to take forward innovative projects that help improve the health and wellbeing of communities.

“Thanks to generous donations to our COVID-19 appeal, we were able to provide initial funding for ‘MyTailoredTalks’ and are delighted to see this now being extended to Midlothian.

“This has been a great example of partners coming together from across the sector to put in place innovative solutions that support our communities dealing with the effects of Long Covid.”

Pogo Studio designed MyTailoredTalks, which recently won the Technology Enabled Independent Living Award at the Digital Health and Care Awards 2023.

Jack Francis, Managing Director of Pogo Studio, said: “This has been a fantastic, collaborative partnership to bring our expertise in technology to, and we have learnt hugely from working with NHS Lothian, Chest Heart & Stroke Scotland and people living with Long Covid.

“Long Covid continues to be a huge issue across Scotland and so we’re delighted that our work so far is demonstrating that MyTailoredTalks can help to support people in their recovery.”

Clinical trial provides new approach for people with eye disease to increase NHS capacity

A UK-wide study, led by Queen’s University Belfast, has shown how a new surveillance pathway for people with stable diabetic eye disease is safe and cost-saving, freeing up ophthalmologists to evaluate and treat people requiring urgent care. 

The new health care surveillance pathway may help ophthalmic units across the world to improve their capacity whilst saving patient’s sight. It is already having a positive impact on the re-design of NHS services across the UK, having been implemented successfully in several hospitals. 

The research, funded by the National Institute for Health Research (NIHR), has been published in leading journals including Ophthalmology, BMJ and NIHR’s Health Technology Assessment. 

The EMERALD (the Effectiveness of Multimodal imaging for the Evaluation of Retinal oedemA and new VesseLs in Diabetic retinopathy) diagnostic accuracy study tested a new “ophthalmic grader” pathway. Rather than ophthalmologists, this pathway involves trained graders monitoring people with previously treated and stable complications of diabetic eye disease, namely diabetic macular oedema (DMO) and proliferative diabetic retinopathy (PDR), based on the reading of images and scans of the back of their eyes.  

The grader’s pathway can save £1390 per 100 patients, and the real savings are the ophthalmologist’s time, which can then be redirected to the evaluation of people at high risk of visual loss. 

Professor Noemi Lois, lead researcher and Clinical Professor of Ophthalmology from the Wellcome-Wolfson Institute for Experimental Medicine at Queen’s University Belfast, explains: “Diabetic macular oedema and proliferative diabetic retinopathy, the main sight-threatening complications of diabetic retinopathy can cause blindness if left untreated. It is therefore important to diagnose them and to treat them timely.

“NHS hospitals eye units are under significant pressure given the extremely high number of people that need to be examined and treated and given the insufficient number of ophthalmologists in the UK. Currently, ophthalmologists need to evaluate all patients, even those that are stable after treatment and who are doing well.” 

In EMERALD, trained ophthalmic graders were found to achieve satisfactory results when compared to standard care (i.e., ophthalmologists evaluating patients in clinic) while releasing ophthalmologist’s time. 

Professor Lois added: “EMERALD showed trained ophthalmic graders are able to determine whether patients with diabetic macular oedema or proliferative diabetic retinopathy previously successfully treated remain stable or if on them the disease has reactivated.  

“Thus, they would be able to follow people that have been already treated, releasing ophthalmologists’ time. Ophthalmologists could then use this time to treat timely other patients, for example, those who have indeed diabetic macular oedema or active proliferative diabetic retinopathy and who have not yet received treatment saving their sight.” 

Dr Clare Bailey, consultant ophthalmologist at the Bristol Eye Hospital, said: “The important data from the EMERALD study has helped us to significantly increase the numbers of people with diabetic retinopathy being seen in ‘imaging/grading’ pathways.

“This has hugely increased our follow-up capacity, whilst allowing ophthalmologists’ time to be directed to the people with diabetic retinopathy who need treatment or further assessment. 

“This has helped us to deal with the capacity pressures as a result of Covid -19 as well as the longer-term capacity demands due to the increasing prevalence of diabetic retinopathy.” 

Dr Caroline Styles, Consultant Ophthalmologist with NHS Fife, added: “Emerald provided us in NHS Fife with the relevant evidence that allowed us to redesign our pathways for people with diabetic eye disease.

“The involvement of people with diabetes in this study reassures our population that these are safe and appropriate changes, and not just based on cost.” 

The EMERALD study was set in 13 National Health Service (NHS) hospitals across the UK and is a large multicentric, UK-wide, National Institute for Health Research (NIHR)-funded diagnostic accuracy study.