Spirometry testing is key to diagnosis of asthma and COPD and is recommended by NICE as part of the diagnostic pathway. However, there is currently a lack of capacity, equipment, and staff with the relevant training in the NHS to conduct this test, particularly in the community setting.

Therefore, patients are often being diagnosed, monitored, and treated for these conditions without spirometry routinely being conducted or adequately performed, leading to sub optimal patient management and contributing to hospital admissions. In some areas of Greater Manchester, admissions for COPD are more than twice the national average for emergency admissions and almost double the national mortality rate. ¹

The COVID pandemic has hindered attempts to improve diagnostic testing for these patients and current backlogs are at an all-time high. Therefore, Health Innovation Manchester, working in partnership with AstraZeneca UK, are looking at the feasibility of a new remote spirometry service as a way of addressing these backlogs.

Remote spirometry uses a Bluetooth connected spirometry device that a patient can use from home to measure how much air a patient can breathe out in one forced breath. The reading is then synchronised with an app that transmits it to a clinical portal. The app will guide the patients using the device and also offer live, online coaching from a trained professional.

A Phased Approach

As part of Greater Manchester’s Health Innovation Accelerator, Health Innovation Manchester and AstraZeneca UK are launching a feasibility pilot from North Manchester General Hospital to test the feasibility of remote spirometry. The project is called ASPIRE: ‘Access Spirometry Remotely in Greater Manchester’.

Phase 1: Evaluating the remote spirometry service in a representative sample of approximately 50 eligible spirometry patients.

Phase 2: Proof of Concept evaluation in the community setting with a wider cohort of approximately 1000 eligible patients.

Phase 3: Review and improve the service for majority and minority groups of users and identify who the service is not suitable for. Where this service is found not to be suitable for certain cohorts of patients, alternative provisions will be identified and put in place.

Benefits to Patients and the Health and Care System

The benefits of the programme are to be assessed through this phased approach. However, it is thought that the programme will be able to demonstrate that remote spirometry can be at least as cost effective to deliver, and easier to access, than services currently offered, allowing for:

• Patients presenting to their GP with symptoms relating to COPD or asthma to have quicker access to spirometry remotely guided by a suitably trained clinician in order to aid diagnosis and treatment.
• Reduced burden on current services and reduced backlog of patients waiting for spirometry.
• More appropriate activation of care and a reduction in inappropriate use of specialist and acute services and allows the right treatment to be delivered, quicker.
• Fewer patients attending Emergency Departments with worsening of their condition because of inadequate treatment.
• Reduced burden to secondary care in delivery of the spirometry service and management of the backlog.
• Improved engagement and access of the service to minority groups and deprived populations.

Overall, providing remote spirometry access to patients will help to improve the quality and safety of care provided to current and potential COPD and Asthma patients in the community.

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

This project is part of a joint working agreement between Health Innovation Manchester and AstraZeneca UK.

Reference

1. The GM Respiratory Improvement Framework

GB-52031 Date of preparation February 2024

The Health Innovation Accelerator

The Health Innovation Accelerator encompasses two projects, the Advanced Diagnostics Accelerator and the DEVOTE programme, delivered through a partnership between Health Innovation Manchester, Manchester University NHS Foundation Trust (MFT), The University of Manchester, and industry partners.

This project is part-funded by the Greater Manchester Innovation Accelerator programme. Led by Innovate UK on behalf of UK Research and Innovation, the pilot Innovation Accelerators programme is investing £100m in 26 transformative R&D projects to accelerate the growth of three high-potential innovation clusters – Glasgow City Region, Greater Manchester and West Midlands. Supporting the Government’s levelling-up agenda, this is a new model of R&D decision making that empowers local leaders to harness innovation in support of regional economic growth and help attract private R&D investment and develop future technologies.