Respiratory Infections Health Integration Team review of 2014-15

Professor Alastair Hay, Director of the Respiratory Infections Health Integration Team (RuBICoN HIT), gives an update on the HIT’s activities in 2014-15.

Every winter health
care services are overwhelmed by patients with respiratory tract infections
(RTIs). Children play a key role in respiratory infection transmission, with
enormous cost implications for societies and healthcare systems worldwide. And
increasing patient demand for and use of antibiotics reduce their
effectiveness. The Respiratory Infections HIT (RuBICoN) aims to reduce the
burden of respiratory infections on both the NHS and the community.

Our active PPI group informs our grant applications and has
given guidance on the information materials we produce, supporting the
translation of evidence into practice.

We have led changes to the bronchiectasis HOT clinic at
North Bristol NHS Trust, allowing individuals to make direct contact with the
clinic when they are unwell, facilitating rapid access to specialist care. We
hope this will result in faster, more appropriate care and reduce hospital
admissions.

The NIHR Health Technology Assessment programme has funded
an evaluation of analgesic ear drops as an alternative to antibiotics for
middle ear infection pain, a common respiratory infection of children. We have
also received NIHR Health Protection Research Units funding for a community-based
prospective cohort study, to investigate the determinants of primary care use
for children with RTIs. This will lay the foundations for an intervention to
improve parents’ use of primary care.

One of our Medical Microbiologists, Richard Brindle, has
worked closely with the GP support unit at the Bristol Royal Infirmary to
review patients and reduce admissions. Our clinical trial on cellulitis has enabled
us to reduce admissions and their duration, by providing a safe system for
outpatient management. We are also collecting information on intravenous versus
oral treatment, which may allow some patients with cellulitis to be safely
managed on oral antibiotics.

We have completed mapping the educational provision around
infection prevention and control in the NHS locally. We will extend this to
encompass information from local authorities, the Department for Education and
Public Health England, to inform educational packages for all carers of
pre-school children including child minders, nurseries and Sure Start staff.