Respiratory infections project takes another step forward

An innovative scheme to improve the diagnosis of patients with suspected acute respiratory infections is to be extended in the North West Coast.

The Community Acute Respiratory Infections project, or CARI, aims to mitigate the impact of infections on winter pressures faced by the NHS in the flu season.

Health Innovation North West Coast is leading the project on behalf of the NHS England North West Point of Care strategy group which delivers point-of-care testing as part of a test-and-treat community pathway.

Funded by the Office of the Chief Scientific Officer, the project aims to generate more data to prove the value of the pathway to clinicians.

Patients who present with flu-like symptoms will be offered a test using machines that deliver results within half an hour. An early and accurate diagnosis can prevent severe illness, avoid hospitalisations and death, and improve antimicrobial stewardship.

The work builds on a project to develop a test-and-treat community pathway for flu that focused on GP practices and offered greater diagnostic certainty while supporting the more appropriate use of antiviral treatments.

That work then expanded to include coronavirus and respiratory syncytial virus (RSV), a common cause of colds that can be serious in more vulnerable patients.

The latest step in the work will focus on two urgent treatment centres (UTCs), one in Liverpool City Region and one in Lancashire, and aims to treat enough patients to significantly enlarge the evidence base. You can read more about our work so far on our website.

Health Innovation North West Coast will work with community and pathology teams to explore whether the diagnostic pathway is appropriate for UTCs and assess its acceptability in both inner city and mixed settings.

Earlier Health Innovation North West Coast research found it was acceptable to patients and clinicians in primary care settings.

The latest project also adds a C-reactive protein, or CRP, test to the process which can distinguish between viral and bacterial infections. This gives clinical staff more information to inform their treatment plans.

Mandy Townsend, Associate Director of Patient Safety at Health Innovation North West Coast, said: “This is exciting work that improves outcomes for patients and can help ease pressures on the healthcare system at a time when a surge in flu and other respiratory infections can exacerbate them.

“Our previous work has demonstrated that both patients and clinicians like the test, but now we want to press on and generate even more evidence so we can drive its wider spread and adoption.

“We want to extend the test to urgent treatment centres to see if the pathway is appropriate in those settings. The throughput of patients will be big enough to give us some solid evidence about how well it works.”

Helen Liggett, Regional Healthcare Science Lead for NHS England in the North West, said: “Health Innovation North West Coast have given this work some real momentum in the past and we’re confident they’ll keep up the pace.

“This collaborative approach is a game-changer in delivering diagnostic testing in the community. Crucially, the work also contributes significantly to antimicrobial stewardship which is a national medicines priority.”

Dr Paula Cowan, Regional Medical Director for Primary Care at NHS England in the North West, said: “This is a good way to support management in the community, reassure patients and avoid hospitalisation and gives our patients a first-class service.”