Itchy, Sneezy, Wheezy 2 - Allergy Care Pathway Rollout in Outer North West London
A third of the population have allergies with a direct cost to the NHS of >£1 billion annually. Despite evidence-based guidelines for allergy care, adherence and diagnostic ascertainment is low and morbidity remains high. 89/195 deaths from asthma and anaphylaxis in 2012, could have been avoidable with better UK asthma guidelines. Historically children in NWL have high hospital admission rates which can be reduced by better patient care and education. This was demonstrated by the CLAHRC NWL ISW study that introduced new care pathways, staff training and online resources which reduced emergency admissions and repeat attendances by 22% across three NWL boroughs.
ISW is a children’s allergies integrated care program. This includes educational programmes for GPs, community health professionals and schools to manage allergy care closer to home. ISW provides more specialised care by GPs and in schools.It increases awareness and knowledge and a specialist nurse-led service brings expert care closer to home. The programme has delivers 79 Consultant-led clinics and 7 nurse-led clinics and has an educational website available to the public.
ISW was rolled out to 3 outer London CCGs. Community based asthma services were commissioned by Hillingdon CCG (£134K annually), to develop asthma friendly schools and asthma education. Investigation of adaptation of the ISW intervention to local needs and priorities, across multiple sites, focused on the role of Quality Improvement methods and the core components of the paediatric allergy care pathway intervention. A specialist allergy network spread evidence-based best practice across NWL (Warner, Spitters 2017). The ISW team are continuing to support roll out beyond NWL in Sheffield, Warrington, Moscow and Sub-Saharan Africa.