Torbay Care Trust has successfully set up, through practice based commissioning (PBC), a locally enhanced service (LES) for patients with chronic obstructive pulmonary disease (COPD).

They are following Chilcote Surgery's successful service redesign model for improved care for patients with COPD

The PBC framework aims to pump-prime practices for one year with the aim that savings made through reducing admissions will ensure that longer term funding is in place to maintain the service.

There are 2 components to the LES which the PCT will pay:

Component 1: £1000 - paid upfront to recognise the extra work involved for the practice.

This work includes:

1. Validating existing registers and stratifying patients into four groups
2. Holding an annual review meeting and completing a practice action plan
3. Identifying high risk patients and ensuring each has a treatment plan in place
4. Putting in place a self care warning system when forecasts predict that risks of illness are high.

Component 2: £10 per patient on the COPD register, paid on receipt of an audit report demonstrating the changes in unscheduled admission.

Practices will be asked to:

1. Identify and validate the register of people with COPD and stratify them into 4 risk groups
2. Ensure care plans/yellow folders are in place for the most seriously at risk
3. Identify a practice COPD lead
4. Hold a multi-professional annual review meeting and produce a practice based action plan
5. Contact the people most at risk and ensure they are aware of self care measures
6. Receive and act on forecasts reports from the Met Office.