Lindsey Lodge Hospice and Healthcare has been showcasing how North Lincolnshire people living with life-limiting lung conditions - and their families - are benefiting from its Breathe Easy Enablement Programme (BEEP) at a national conference.
Lindsey Lodge Advanced Care Practitioner Sarah Hodge, was selected to present a poster presentation at this year’s Hospice UK Conference in Glasgow in November 2022, which demonstrated how the evidence based intervention - BEEP - is supporting people living with a range of conditions including Chronic Obstructive Pulmonary Disease (COPD), Pulmonary Fibrosis, Bronchiectasis and Cancer.
Sarah said: “People with lung problems often suffer from breathlessness completing everyday tasks such as walking, getting dressed or doing jobs around the house. This can make them panic or feel frightened, to the point where they, or a family member may feel the need to dial 999 for an ambulance. It can sometimes feel as though their breathlessness controls them, that doesn’t need to be the case, we’ve seen very poorly and breathless people regain some control by following the techniques outlined in the BEEP.”
She added: “Before we introduced BEEP, patients were waiting up to 18 months to be assessed for our Breathlessness Clinic, there were 74 people on our waiting list because we didn’t have the physical capacity to support them. Sadly, this meant that people were dying before receiving an assessment.”
BEEP was introduced at Lindsey Lodge in 2019, thanks to £40k Hospice UK grant award through St James’s Place Charitable Grant Programme. It was converted to be delivered remotely in line with Covid-19 guidance. Following the lifting of restrictions, the BEEP programme returned to face-to-face group sessions and has continued to evolve over the past three years into a well-established part of Hospice care.
The eight-week Programme is a collaboration of professionals based within the Hospice and externally with consultants, complex care matrons and psychological services.
Patients complete an hour of exercise in Lindsey Lodge’s Re-enablement Gym, which are led by the physiotherapist, or advanced care practitioner occupational therapist and advanced assistant (referred to as the programme’s dedicated practitioner).
In parallel to this, the patient’s carer will be able to access a separate session focusing on relaxation, counselling support, or an hour of respite. This is followed by an hour of education for both patient and their carer.
The education sessions include breathing control and management strategies, exercise, and disease management including: Smoking cessation, fatigue and energy optimisation, sleep, pain, managing anxiety and stress and future/advanced care planning. Multiple professionals both internal and external to the hospice deliver the education sessions.
Sarah said: “We have drastically reduced the waiting list for this service. The average time from referral to assessment is currently four weeks, and we’re seeing around 35 patients at any one time.
“Delivering BEEP in the group setting provides enhanced peer support for patients, which often continues long after the eight weeks of the actual Programme, this can help reduce the need for re-referrals.”
She added: “It’s the first programme to offer a carer respite/support session in parallel, which alleviates pressure and support with coping and the future. 100% of the carers who’ve taken part in BEEP felt that it helped them to cope better with their family member’s condition, and they would be less likely to call 999, which obviously reduces the number of hospital admissions and A&E attendances for the acute trust.”
BEEP has also seen an improvement in collaborative and partnership working between the Hospice, acute trust, community services and the primary care sector. It also reduces silo working, as at present, elements of BEEP are delivered individually across these sectors.
BEEP integrates these clinics, therefore rather than the patient and carer attending on average 20 appointments, they can attend one specific programme of care enabling them to spend more time at home.
Sarah said: “Our statistics speak for themselves! 90% of our patients have reported improvement in their breathlessness and a reduction in their level of fatigue and 80% told us they’d experienced an improvement in their overall wellbeing.”
She added: “We’ve also been able to support a colleague from our health partners. A staff nurse from the acute trust who developed Pulmonary Fibrosis after Covid, has completed our BEEP and is now able to return to work, so it’s lovely to be able to make such a difference.”
Lindsey Lodge would like to develop the service further and apply it within its Inpatient Unit, but this depends on securing appropriate funding in the future.