Respiratory care action plan draft: consultation report

Question 1: Vision and aims

'Do you agree with the overall vision and aims of this draft plan?'

Option	Total	Percent
Yes	102	85.71%
No	6	5.04%
Don't know	9	7.56%
Not Answered	2	1.68%
Total	119	100%

A total of 117 people responded to question one, with 52 responses being expanded to include comments. Of those, a majority (102) agreed with the overall vision and aims of the draft plan, with a minority disagreeing (6) or not knowing (9). 2 respondents did not answer the question. To further breakdown those who responded to the above question: 

• NHS (boards and organisations) 11
• Third sector organisations 15
• Private sector companies 6
• General public individuals 85

There was widespread agreement across all responses that a respiratory care action plan is needed. The majority of expanded comments noted suggestions for improvement or noted that the Plan had not set out enough detail, particularly with regards to Covid-19. Due to the open nature of the question, the responses were extremely varied in subject. Many respondents took the opportunity to make comments which were more relevant to later questions in the consultation.

Breakdown of the most common themes:

Health boards

Some respondents were of the view that there should be local health board level measurements of any targets set by the Plan, requesting that respiratory care is made a national priority to allow increased access and increased choice. 

Equal access 

In total, some respondents commented on the commitment on equal access. General themes included geographical variation in access to care (for example, rural and remote), inequality in health outcomes, and inequality in service provision. Respondents also highlighted the effects of fuel poverty on symptoms and self-management of people living with a respiratory condition. 

Data/technology 

Those responses which considered data and technology tended to agree that both are important, especially during and post Covid-19. Clarification was requested around the phrase "innovative ways", and whether it means technology enabled care solutions. 

The majority of respondents were of the view that there is a need for an increased roll out of digital services and virtual clinic models. This would allow for increased access to pulmonary rehabilitation both digitally and in person, which is important in rural or remote areas. The comments around data focused on its use for remote management of conditions, increasing the capacity of respiratory services to deliver to people with respiratory conditions. It was also noted that improving data collection was vital to service delivery and to allow for a better understanding of demand.

New models of care

Calls were made for a national policy on models of care, including the development of a standardised approach to respiratory medicine and a robust pathway for patient care. Respondents highlighted the perceived inconsistencies in care across Boards, and that having a standardised care pathway would ensure best practice. 

Anticipatory care planning / end of life care

Anticipatory Care Plans (ACPs) and end of life care were both mentioned in the responses. Clarification was requested around end of life care, and what the current processes are. Early conversations were encouraged around ACPs.

Person-centred care

The importance of person-centred care was highlighted by the majority of respondents, who noted that individualised care and personalised support were essential for the wellbeing of someone living with a respiratory condition. 

It was suggested by other respondents however that instead of patient-centred, a patient's journey should be more of a partnership between people with a respiratory condition and clinicians. Others suggested that when people are not empowered to take ownership of their care and treatment, they are negatively impacted. 

Multi-disciplinary teams

Respondents felt that Allied Healthcare Professionals (AHPs) and pharmacists were underrepresented within the Plan, as was the idea of multi-disciplinary teams (MDTs) within the patient journey. 

Workforce

Respondents highlighted staff as key to supporting delivery of the Plan. It was noted that greater staffing levels would allow for continuity of care across the patient journey. 

Funding

The issue of funding was raised, particularly investment to support delivery of the Plan at a national, local and community level. 

Covid-19

Whilst it was acknowledged that the draft plan was written before the Covid-19 pandemic, the responses noted the importance of the final Plan reflecting the impact Covid-19 has had on people with existing respiratory conditions as well as those that have developed long-term respiratory problems as a result of contracting the virus.  They felt the Plan needed to respond to the implications for many aspects of respiratory care going forward. 

Format of the Plan

There were a number of comments made by respondents around the layout and content of the Plan. 

The need for a consistent approach to style within the document was highlighted. Respondents also asked for clarification around why the Plan focuses on five specific conditions and not all lung conditions.

There was variation across responses regarding the overall ambition of the Plan. While some respondents felt that the plan was bold with a concise vision, others felt that the Plan lacked ambition and was too generalist. 

Some respondents felt that the plan required further input from those living with respiratory conditions, their families or their carers. Clarification on third sector and private sector involvement was also requested. 

Gaps in the Plan

There were some areas where respondents felt the Plan could be strengthened. This included the inclusion of preventative measures, raising awareness of respiratory conditions, support for older people, families and carers, care in early years, and the transition of children and young people with existing, lifelong conditions into adult services. The importance of ensuring the Plan makes the necessary links to other, relevant Scottish Government plans and strategies, particularly around carers, was noted. 

Some respondents were of the view that objectives and targets may strengthen the Plan, in particular measurable targets to help drive improvement in care and deliver better outcomes for patients with respiratory conditions. 

A chart showing phrases from the Q1 responses. Gaps in the plan had 43 mentions; health boards had 4.

A chart showing phrases from the Q1 responses. Gaps in the plan had 43 mentions; health boards had 4.