About the project
The Asthma + Lung UK Respiratory Champions pilot project has funded six ‘Respiratory Champions’ within six local NHS areas, known as Integrated Care Systems (ICS), within England. These Champions are already local respiratory specialist Health Care Professionals, but this project is giving them more time and resources to enhance respiratory care and work in a broader way to improve outcomes.
The Champions have initially focused on asthma and COPD, mapping local outcomes and services provision and then worked with A+LUK to formulate an ambitious plan of action. They are now working on these plans and starting to implement positive changes.
The Respiratory Champions have each been provided with a grant for a 12 month fixed contract so that they can work one day a week in this important role. The project is funded by a grant from AstraZeneca, however A+LUK has full operational control.
A+LUK aims to attract additional funding in future years, and should the pilot be a success, we aim to expand the scheme and work with a larger number of ICS'/Health Boards.
The Respiratory Champions project is managed by Claire Fisher, Respiratory Nurse Specialist and Advanced Nurse Practitioner.
Respiratory Champions key action plans:
Respiratory champions work directly with healthcare professionals (HCPs) across the system and with local NHS leadership and management to shine a light on respiratory conditions and services in that area. The Champions play a pivotal role delivering improvements to people with lung conditions.
They have each developed an action plan by drawing on their areas of expertise and interest and by conducting a landscape analysis which used both qualitative and quantitative data to identify gaps in the quality of care and prioritising local respiratory needs.
These ambitious action plans detail the actions the champion will take to improve local respiratory care, and the improvement needs required for better outcomes for people with COPD and asthma, such as implementing new policies, guidelines, pathways, and clinical practice, as well as building a broad network of supporters across their area.
Meet the champions
Samantha Hayes – Consultant Respiratory Physiotherapist for Cheshire and Merseyside ICS
Sam is a consultant respiratory physiotherapist, with over 20 years’ experience working within the NHS, and has for the last 12 years worked in an integrated community respiratory service in Knowsley. As part of this role Sam is involved in respiratory diagnostic and optimisation clinics and is a non-medical prescriber.
Sam also provides senior clinical oversight to the local acute respiratory infection virtual ward. Sam is the clinical lead for pulmonary rehabilitation (PR) for Cheshire and Merseyside (C&M) and has worked with all nine PR service to agree and design a single PR service spec for the region to reduce variation in PR provision across C&M.
Sam is currently undertaking a PhD looking at how peer interventions can increase uptake in pulmonary rehabilitation.
Sam's action plan
Sam is taking a comprehensive and proactive approach to improving respiratory health in Cheshire and Merseyside (C&M), addressing its high levels of SABA overprescribing and monotherapy use. Central to her plan is the implementation of updated asthma pathways and guidelines, designed to promote evidence-based prescribing practices and improve patient outcomes. To support this, Sam is placing a clinical respiratory leader in each PCN across C&M. They will guide best practices in asthma and COPD care, ensuring that local teams have the support and expertise they need. Recognising the importance of education, Sam has also prioritised upskilling HCP’s by organising respiratory educational events across the region.
Sam is also focusing on improving diagnostics, particularly in The Wirral where mapping efforts have identified this area as requiring urgent attention. Sam is playing a key role in a project to enhance COPD care where HCPs are being deployed to conduct targeted COPD reviews for patients identified through Targeted Lung Health Checks (TLHCs). The Respiratory Champion role has enabled Sam to directly oversee and clinically supervise this project. This hands-on approach reflects Sams dedication to ensuring high-quality, evidence-based care and driving sustainable improvements in respiratory health across C&M.
Recently, Sam was involved in a World COPD event for C&M, where Strictly Come Dancing celebrity Shirley Ballas helped inspire COPD patients to exercise through dance. This creative approach highlights Sams commitment to promoting innovative strategies that empower patients to improve their lung health and well-being.
Victoria Campbell – Respiratory Nurse Consultant for Staffordshire and Stoke-on-Trent ICS
Vicky Campbell is a Respiratory Nurse Consultant who clinically leads a large community based multi-professional respiratory team in Staffordshire on behalf of Midlands Partnership University Foundation NHS Trust.
Working in the NHS as a registered nurse for 30 years, Vicky has spent time equally in community and acute hospital care settings. Her experience covers not only respiratory medicine and emergency portals, but also has a wider interest in long term conditions.
Vicky has been a strong advocate for improving respiratory care in Staffordshire, delivering educational support to colleagues and students across many service areas.
Victoria's action plan
A major part of Vicky’s plan is to work closely with senior healthcare leaders to make respiratory care more streamlined and equitable throughout S&SOT ICS. With Vicky’s extensive experience and knowledge of how patient pathways in the area are currently run, she is a key contributor to laying foundations for establishing improved pathways for COPD and asthma patients in both secondary and primary care.
This involves reorganising community teams to run more efficiently, as well as creating better communication channels between primary and secondary care staff. She is replicating good practice within the ICS where it is needed most. Her action plan hopes to shine a light on the benefits of improving access to quality diagnostics and therefore timely treatment regimens for respiratory patients across the ICS. She has recently successfully engaged with her local MP to garner political attention.
Her position has placed her well to be a strong advocate for patients and respiratory HCPs to support senior stakeholders to change and improve policy through her landscape report analysis of S&SOT, and in conjunction with her own clinical insights.
Vicky is also linking into local plans for the implementation of new BTS/NICE asthma guidelines to help combat SABA overprescribing, improve patient outcomes, reduce environmental impact, identify poor asthma control, and improve access for patients to severe asthma services for consideration of biologics.
Vicky is also acting as a clinical educator for health care professionals and is upskilling her networks. In addition to this she also has a long-standing role in the local Breathe-easy groups which S&SOT are extremely proud of.
Deborah Leese – Lead pharmacist respiratory/Co-clinical Lead CYP Asthma for South Yorkshire ICS
Deborah studied pharmacy at the University of Bradford qualifying in 2000 with a first class honours degree. She has held various roles in the private sector and joined the NHS in 2009 holding clinical pharmacist roles for Sheffield PCT, South Yorkshire and Bassetlaw Commissioning Support Unit, Sheffield CCG and currently South Yorkshire ICS.
In 2016 Deborah qualified as a pharmacist independent prescriber from Robert Gordon University Aberdeen and during that training chose respiratory as her clinical area of interest. She was appointed as lead pharmacist for respiratory for the Sheffield Medicines Optimisation Team in 2016. Since then she has led on the development of local guidance for asthma and COPD. She has also developed many initiatives for inhaler optimisation. Deborah chairs the South Yorkshire Sustainable Respiratory Group and the South Yorkshire Respiratory Medicines Group. She is Vice Chair of the service development committee for the Primary Care Respiratory Society, is part of the PCRS Asthma Right Care core team and sits on the PCRS Policy Forum.
Most recently Deborah has been appointed as Co-clinical Lead for CYP Asthma for South Yorkshire and is looking forward to working with Asthma + Lung UK as part of the Respiratory Champions Project.
Deborah's action plan
After reviewing the needs of South Yorkshire Integrated Care System, she is focusing on implementing Asthma Guidelines which promote Global Initiative for Asthma (GINA) strategies for asthma to reduce SABA over-prescribing and use. Since starting this work there has already been a significant reduction in SABA prescribing in Sheffield. The Respiratory Champion role is now enabling her to implement this approach across the rest of South Yorkshire.
Deborah and her team are involved in the ‘DAISY’ project. ‘Delivering Asthma Improvement in South Yorkshire’ identifies GP practices within the most deprived areas where over prescribing of SABA is very high. These practices are offered additional training, support and interventions to optimise asthma care. Additionally, she is developing and implementing a COPD medicines optimisation plan in Sheffield and Barnsley with a view to eventually widening the approach across South Yorkshire.
A crucial part of all this work is the upskilling of the workforce across South Yorkshire in the form of a “Respiratory Champions Network” across primary care. The network provides “the skills and tools needed to become change enablers within their workplace, share best practice, and develop local quality improvement projects. In addition, the network is providing “Audience with” sessions where the local HCPs can bring cases and ask questions to clinical experts.
Deborah also has a strong Children and Young Persons (CYP) role and is developing asthma friendly schools and clubs as part of her role. As part of this she is planning some health improvement work with a particular focus on health inequalities and the use of technology to identify children that potentially have asthma or poorly managed asthma.
Maria Eurton – Clinical Respiratory Nurse Specialist for Hampshire and Isle of Wight ICS
Maria has worked in respiratory medicine since qualifying as a registered nurse in 2010. She has experience in acute respiratory nursing and research nursing, before becoming a respiratory nurse specialist in 2014. She has also worked in the private sector which allowed her to work within different ICS', providing mentorship and education for practice nurses, GPs and other allied health professionals. She regularly delivered respiratory education modules on a 1:1 basis and in larger groups.
Maria currently works as a clinical respiratory nurse specialist at a large Primary Care Network in Southampton. She supports healthcare professionals within the PCN and reviews respiratory patients with complex needs. She works closely within the Urgent Care Team to provide acute respiratory care for patients and optimise their treatment based on the most current guidelines.
Maria has level 6 and 7 courses in COPD, Asthma, Respiratory Diagnostics and Non-Medical Prescribing. She won the Association of Respiratory Nurses Respiratory Rising Star award in 2016 and is currently the diagnostics lead for ARNS. She is part of the Southampton City Airways Forum committee and is passionate about improving and maintaining communication links between Primary, Secondary and Tertiary care.
Maria's action plan
Maria is implementing a new primary care annual review pathway to provide more timely reviews for patients; prioritising those who need an urgent review such as ‘high risk’ patients and post exacerbation. She is driving the implementation of the new SCOPES template for patients’ post-COPD exacerbation by planning to disseminate the SCOPES tool amongst practices early in 2025, and upskilling staff in its use. “SCOPES” stands for: smoking cessation, co-morbidities, optimisation (of treatment), pulmonary rehab, exacerbation history (including blood eosinophils) and self-management.
In addition to this, an optimisation template for asthma is in production called "PEAR" (post exacerbation of asthma review). These tools will undoubtedly reduce unplanned admissions but also give higher risk patients access to evidence–based treatment within a timely manner.
Maria is expanding her networks and is now in contact with more PCNs due to her Respiratory Champion title.
She has 5 sessions booked for 2025 to speak at the next TARGET educational events and local Primary Care Respiratory Conference.
She is also evaluating health care professionals’ skill mix and has conducted a survey which combined with regional data has helped Maria better understand, where her networks need upskilling.
Additionally, Maria is involved in work for HIOW to review referral pathways to Secondary care, overseeing the development of a local breathlessness pathway and reviewing the availability of diagnostics within the ICB.
Matthew Swallow – General Practitioner with an extended Role in Respiratory Medicine for Birmingham and Solihull ICS
Matthew Swallow graduated with distinction from Peninsula Medical School in 2012. After completing his foundation training in the West Midlands, he joined the South Birmingham GP Vocational Training Scheme. During his GP training, he was awarded an Academic Clinical Fellow post at the University of Birmingham, working on several projects with the Birmingham Lung Improvement Studies (BLISS) team. He completed an MSc in ‘Clinical Primary and Community Care’ with a respiratory research focus.
Dr. Swallow is a GP partner and trainer at Bournbrook Varsity Medical Centre. In January 2020, he began working in various Community Respiratory Clinics across Birmingham and the Black Country. He was formally appraised as a GP with an Extended Role in Respiratory Medicine in August 2020.
Currently, Dr. Swallow is the Respiratory Lead for the SDS myhealthcare federation, serving nearly half a million patients with a community respiratory service and diagnostic hub. In his Respiratory Champion Role, he will work as a senior leader in Birmingham and Solihull ICS to redesign respiratory diagnostic and management pathways. His focus will be on developing a sustainable, data-driven approach to community respiratory diagnostics and management. He will foster collaboration between primary and secondary care for integrated service provision.
Matthew's action plan
The Respiratory Champion role has enabled Matthew to become the ICB community respiratory lead which means he now has a lot more opportunity to influence senior healthcare leaders. His engagement and collaboration with a wide range of stakeholders has also widened
His mission for the Respiratory Champion role is to improve access to quality assured diagnostics for patients in BSOL ICS. He has completed a detailed options appraisal for community respiratory diagnostics and has developed a business case for the development of a Local Initiative Scheme (LIS) to expand spirometry and FeNO testing across PCNs within BSOL. This initiative if adopted will empower PCNs to independently run spirometry testing meaning greater access for patients. It will also standardise diagnostic availability with BSOL ICS, thus reducing pressures on secondary care and giving patients access to timely diagnoses.
Matthew has also engaged with his local labour MP for Birmingham Erdington, Paulette Hamilton, which has resulted in her asking the Secretary of State for Health and Social Care what steps his department is taking to support Birmingham Erdington constituency and other areas covered by Birmingham and Solihull ICB to address the barriers to respiratory diagnostics identified in the report entitled Right Test, Right time, published by A+LUK August 2023.
Matthew has also been instrumental in the implementation of the breathlessness pathway, and a diagnostic pathway for children and young people, to standardise management of unexplained breathlessness across primary and secondary care.
Furthermore, Matthew is involved in updating the local asthma guidelines which will be based on the new NICE/BTS guidelines. As part of this educational sessions on asthma management will be implemented focusing on reducing SABA use in BSOL.
Sharada Gudur – Consultant Respiratory Physician for Lancashire and South Cumbria ICS
Sharada started her NHS career as a North-West trainee in 2005 and has rotated through various hospitals in the North-West deanery as part of respiratory specialist training programme. She started working as a consultant respiratory physician since 2016 in Lancashire Teaching Hospitals NHS trust. She is passionate about integrated care and has been working with community COPD team as part of Lancashire and South Cumbria NHS Foundation trust bridging the gaps between the services. She has also participated in NHSE programmes such as 100 day challenge to improve patient pathways and promote self-management working across boundaries with primary care. She had been the acute clinical lead for Lancashire and South Cumbria respiratory clinical network from May 2022 – Feb 2024, which has made her passionate to work towards the respiratory champion role.
Outside of work, she enjoys listening to Indian classical music, sings light music as part of local Indian music group called “Red rose ragas” and spending time with family and friends.
Sharada's action plan
Recognising that care pathways for COPD patients, including Pulmonary Rehabilitation (PR), are often fragmented between primary and secondary care, Sharada has committed to establishing better-integrated systems to streamline care and improve outcomes. Her plans involve creating more cohesive pathways that ensure patients receive timely and effective support, including access to PR programs. To achieve this, she has been engaging regularly with senior stakeholders, working to upskill HCP’s, fostering collaboration across healthcare improvement programmes including NRAP, resulting in creating seamless pathways for patients across various levels of care.
Drawing on previous experience in the local prison system, Sharada has received approval to develop a proof-of-concept multidisciplinary team (MDT) approach to improving respiratory health in prisons. This initiative will help to tackle health inequalities by addressing the specific health needs of an underserved population, while generating evidence of effectiveness and creating a scalable model for wider implementation across her area.
Sharada continues to teach, for example, her annual World COPD HCP event took place in November 2024 and was well attended by HCPs from her area.
Furthermore, as part of her role as a respiratory champion, Sharada is working on the implementation of SABA-free guidelines in L&SC.