P154 A pathway transformation to transition from a ‘routine’ to a ‘responsive’ severe asthma service in the post COVID era

BackgroundHistorical care delivery models in severe asthma have resulted in an extensive burden of long-term follow-up within services leading to significant waiting lists for ‘routine’ appointments. This was exacerbated by the COVID-19 pandemic creating an urgent need to address rising waiting lists and implement novel care pathways maximising remote support for patients whilst ensuring prompt access to the team at a time of clinical need and the continued delivery of safe and effective patient-centred care.MethodsA comprehensive review of the clinic footprint identified 646 patients with difficult or severe asthma awaiting ‘routine’ follow-up (outside of a treatment pathway). A manual risk stratification tool was developed in collaboration with our patient representatives and MDT, with patients triaged into multi-disciplinary clinic streams through a collaborative clinical and administrative process (ensuring previous waiting times, patient risk and need for MDT interventions/treatments were considered). All reviews were undertaken remotely with face to face appointments only where clinical benefits outweighed the risk. A PDSA process was used to concurrently assess the processes for risk stratification, patient discussion and clinic transition.Results638 patients were reviewed May-September 2020 with 59% requiring continued follow-up within the asthma service and 30% safely transitioned from routine follow-up to remote supervision with review at the time of need. 8% were discharged with an SOS appointment and 3% were followed up in an alternative respiratory clinic. The process was well received by patients with the majority feeling confident with their follow-up arrangements. Phenotypic details have been recorded to ensure timely review and access to novel therapies where these become available.Abstract P154 Figure 1A pathway transformation to transition from a ‘routine’ to a ‘responsive’ severe asthma service in the post COVID eraConclusionsThe COVID-19 pandemic has necessitated a comprehensive re-evaluation of services and care pathways across the NHS. Transitioning from a ‘routine’ to ‘responsive’ patient-triggered service has facilitated flexible but personalised care empowering patients in the self-management of their asthma and significantly reducing the burden of ‘routine’ follow-up for patients and the MDT. This has reduced waiting times and increased capacity for new patient assessments whilst ensuring patients are offered timely reviews when