• Led by University Hospitals Coventry and Warwickshire NHS Trust, in partnership with Coventry University, the British Lung Foundation and local voluntary sector groups in Coventry.
  • An innovation for people with severe chronic obstructive pulmonary disease in Coventry.
  • Aimed to improve well-being and reduce the high levels of anxiety and social isolation observed in these patients.
  • Applied an asset-based community development approach to enable individuals to be more active and involved in their community.

RIPPLE is a project that aimed to increase the social inclusion of people with severe chronic obstructive pulmonary disease (COPD), improve their wellbeing, increase their confidence in self-managing their condition and reduce hospital admissions.

COPD is the second most common cause of NHS emergency admissions and causes one in 20 deaths. Its symptoms, including breathlessness and cough, can lead to and amplify anxiety, low self-esteem and social isolation. This in turn can lower mental wellbeing and result in poor self-management and lack of engagement with treatments such as smoking cessation.

A team at University Hospitals Coventry and Warwickshire NHS Trust has applied a whole-system approach to develop innovative solutions for these patients. Following patient consultation, an informal community based clinic was introduced to act as a catalyst for increased community involvement. This group model blends an informal clinic/education session with social activities such as bingo, quizzes, singing and yoga, every week in a community centre. A COPD consultant and nurse are available to answer questions, give self-management advice and see patients more formally. Chaplains and voluntary sector groups also provide a listening service and offer holistic support.

The clinic has resulted in reduced social isolation for these patients, reduced anxiety, increased mental wellbeing, improved confidence in the ability to self-manage, and there is initial evidence of a reduction in unplanned hospital admissions.

As an innovative way of working, challenges that the team had to deal with included cultural and organisational differences between NHS and third sector organisations, and hospital procedures not always being suited to a community based holistic care model.

A Health Foundation funded Spreading Improvement project will implement the RIPPLE model in six local health economies in the East and West Midlands region.