MISSION Project is a collaborative working project between Chiesi Limited and Health Innovation Manchester.

UK-CHI-2400715 September 2024

At Health Innovation Manchester (HInM), we are embarking on an ambitious journey to improve respiratory care in Greater Manchester. MISSION is a collaborative working project between Chiesi Ltd and Health Innovation Manchester and will support direct care of patients with asthma and COPD.

Asthma and COPD are the most common respiratory conditions in the UK, with approximately 5.4 million people living with asthma[1] and 1.4 million people living with COPD[2]. In Greater Manchester, there are 200,000 people living with asthma[3] and 74,000 people living with COPD[4].

It is recommended that respiratory patients should receive reviews at least every 12 months[5]. However, in the UK it’s estimated that only 30% of people living with asthma and less than 20% people living with COPD, receive even basic levels of care.

The MISSION project aims to improve the overall quality of annual COPD and asthma reviews, for patients over the age of 18. It will also help the Greater Manchester Integrated Care System (ICS) to understand how best to support Primary Care to improve the management of respiratory conditions by the utilisation of the LungHealth, a Computer Guided Consultation (CGC) software, provided by NSHI Ltd.

LungHealth software is based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) report and SIGN/BTS Guidelines for Asthma[8]. This software has been developed to promote purposeful history taking and provide prompts to consider guideline-based treatment interventions.

Currently, staff who undertake annual reviews are required to know and understand the latest guidelines to enable robust patient care. Using the LungHealth computer guided consultation software will allow those individuals to utilise the guidelines without needing to remember every detail. As new guidelines are released, the software is centrally updated, ensuring that patients are always treated in line with the most recent advice. The software also ensures that patients are recommended the most appropriate medications and that other linked conditions/concerns are flagged.

Implementation of the LungHealth asthma software has been piloted in the STARRS-GM project[9] (Standardised Asthma Review through Reduction in overuse of SABA) and the COPD software in the COPD Legacy project[10].  Both projects have demonstrated patient and system benefits by improving the overall quality of annual COPD and asthma reviews, for patients and staff. This in turn has given benefits in terms of carbon reduction, lower health care utilisation and broader health and wellbeing impacts for patients.

In developing the MISSION project, we have taken feedback from individuals involved in the pilots, to build on this knowledge and to scale the use of the LungHealth software in up to 150 GP practices across Greater Manchester. GP Practices signing up to the project will be provided with a twelve-month licence to the LungHealth software, for either asthma and/or COPD depending on practice preference, that can support both face-to-face and remote annual reviews. Practices will also be provided with training, mentoring and support throughout the project.

The potential outcomes of the project will be to:

• Ensure patients, aged 18 and over, have an accurate diagnosis of COPD and asthma.
• Ensure asthma & COPD patients receive high quality annual reviews in accordance with current respiratory guidelines.
• Ensure all asthma & COPD patients have their respiratory medication optimised, including a personalised action plan and inhaler technique checked and corrected, where needed.
• Support optimal disease control and improved health related quality of life for patients.
• Ensure appropriate management of asthma and COPD irrespective of level of the clinical experience of staff.
• Improve patient outcomes resulting in less demand for primary care resources, urgent and emergency care services, and non-elective hospital admission.

For more information, please contact: respiratorycomms@healthinnovationmanchester.com.

For an executive summary of the project, please see the Chiesi UK website: https://www.chiesi.uk.com/collaboration-pdf/1_MISSION-project-Health-Innovation-Manchester-Collaborative-Working-Project-Executive-Summary.pdf 

References:

[1] Asthma + Lung UK, What is asthma?: https://www.asthmaandlung.org.uk/conditions/asthma/what-asthma

[2] Asthma+ Lung UK,  COPD in the UK – Delayed diagnosis and unequal care: https://www.asthmaandlung.org.uk/sites/default/files/2023-03/delayed-diagnosis-unequal-care.pdf

[3] Health Innovation Manchester, Understanding asthma management and its links to smoking in Children and Young People (CYP) in Oldham: https://healthinnovationmanchester.com/wp-content/uploads/2024/01/InHIP-Insight-Report-Understanding-asthma-and-links-to-smoking-in-CYP-in-Oldham.pdf

[4] NIHR, Chronic obstructive pulmonary disease highlight notice: https://www.nihr.ac.uk/documents/chronic-obstructive-pulmonary-disease-highlight-notice/25862

[5] NICE, Chronic obstructive pulmonary disease in over 16s: diagnosis and management: https://www.nice.org.uk/guidance/NG115

[6] Asthma + Lung UK, Transforming asthma care in the UK Report, April 2022: https://www.asthmaandlung.org.uk/sites/default/files/Fighting%20back_V3.pdf

[7] Asthma + Lung UK, COPD in the UK. Delayed diagnosis and unequal care report, April 2022: https://www.asthmaandlung.org.uk/sites/default/files/2023-03/delayed-diagnosis-unequal-care.pdf

[8] BTS/SIG, British Guideline on the Management of Asthma: https://www.brit-thoracic.org.uk/quality-improvement/guidelines/asthma/

[9] Health Innovation Manchester, Over 1000 patients in Greater Manchester receive asthma reviews to improve asthma diagnosis and management through STARRS-GM: https://healthinnovationmanchester.com/news/over-1000-patients-in-gm-receive-asthma-reviews-through-starrs-gm/

[10] GlaxoSmithKline (UK Ltd) and Health Innovation Manchester, Summary of “Health Innovation Manchester and GSK Joint Working: Optimisation of care for people living with COPD in Greater Manchester”: https://www.gsk.com/media/11451/greater-manchester-summary-of-outcomes.pdf