Health alerts save lives
28 February 2011
For sufferers of Chronic Obstructive Pulmonary Disease (COPD) even subtle changes in the weather can mean the difference between life and death, which is why the Met Office runs Healthy Outlook® — a world-leading service that lets people with COPD know when difficult weather is on its way.
COPD encompasses a variety of respiratory illnesses, including chronic bronchitis and emphysema. It affects around 900,000 people in the UK and costs the NHS a massive £900 million a year. The cold weather can make symptoms much worse, but so can less obvious factors, such as humidity, the seasonal ebb and flow of diseases and air quality - particularly in summer months. Patients even report difficulties when battling against the wind.
Healthy Outlook® comes into its own by helping to make COPD sufferers forewarned and therefore forearmed. It sends out automated phone calls to 19,000 registered patients, giving them a four-day warning that adverse weather is on its way and cautioning them to take action such as checking their medication, keep their home warm and, if possible, to plan to stay indoors.
"The warnings are far more than a temperature forecast. They are a health forecast - and a vital service for thousands of people in the UK. The service saves lives and helps reduce costs for the NHS."
Wayne Elliott, Head of Health Forecasting
The phone call initially tells them that they are at increased risk of becoming unwell over the next two weeks followed by a couple of questions which require a spoken 'yes' or 'no' answer. These include whether they are feeling ill and if they have enough medication. Patients are also given a 'patient pack' - a highly regarded booklet containing advice from the Department of Health, on how to stay well if you have COPD. The phone advice refers the person to this pack.
Lifting the health burden
Healthy Outlook® is a prime example of how the Met Office's services reach beyond weather forecasting as Wayne Elliott, Head of Health Forecasting explains: "The warnings are far more than a temperature forecast. They are a health forecast - and a vital service for thousands of people in the UK. The service saves lives and helps reduce costs for the NHS. COPD affects the economy too - removing a percentage of the older population from the workforce who are still young enough to work, but can't due to ill-health."
COPD facts and figures
- COPD sufferers in the UK 900,000
- Annual cost to the NHS £900m
- Drop in emergency admissions in pilot project 51%
- Patients found that Healthy Outlook helped them manage their condition better 85%
Keeping doctors informed
To provide the Healthy Outlook® service, the Met Office calls on its expertise in both weather forecasting and its understanding of respiratory virus levels in the community - it's this combination of factors that can put people at risk.
"The health forecast is calculated on a weekly basis," Wayne adds, "by combining health data from sources such as the Health Protection Agency with weather data." This produces either a 'normal' or an 'elevated' state. If the forecast is for elevated risk, the service is activated and the calls are made.
One of the real benefits of this is that GPs participating in Healthy Outlook® can access the results on the Met Office website. At the click of a mouse, they can see how their patients have responded to the Healthy Outlook® alert and whether they might need a new prescription or flu jab. The service also supports national initiatives such as the Department of Health's 'keep warm, keep well' campaign. We sent a postcard (shown below) to GP surgeries advising vulnerable people how to find out more about services provided by the Department of Health, the Met Office and the Department for Work and Pensions.
It's important to ensure Healthy Outlook® is continuously effective, which is why the Met Office Health Programme ran a randomised control trial during the winter of 2008/9. There were 77 patients taking part in Devon and all were given the patient packs, while half were randomly selected to receive the alert calls. This helped correctly identify periods when people were at increased risk.
Following the trial, Healthy Outlook® was piloted by 11 practices within NHS Bath and North East Somerset (B&NES) - with outstanding results. Emergency admissions dropped by 51% and 85% of patients surveyed said they found it helped them manage their condition better. This led B&NES to decide to commission the service for the next three years.
In 2011, 40,000 patients have been signed up to receive Healthy Outlook®. But the Met Office is hoping this number increases to 250,000 people. Not only will patients get the advice they need to keep themselves safe, but the NHS can look forward to some very healthy financial savings too.
Some patients have a tendency to mentally shut down when the doctor tells them they have COPD - a relatively new umbrella term for chronic inflammatory conditions which cause over 30,000 deaths a year. The patient pack, given at the same time the person is signed up to receive alerts, explains and reinforces any information provided by the GP about the disease. But as Wayne explains: "Our research has shown that the older generations, particularly the over 70s, need to be steered away from the Victorian mentality of 'cool rooms and open windows are healthier', when, in fact, this is the worst thing someone with COPD can do."
Non-pharmacological advice in the patient pack includes common-sense tips such as eating well, getting enough vitamins, keeping warm and not going outside in the freezing cold. Working with this advice, the alerts help the patient plan ahead. For instance, when they receive an alert, they have the chance to buy vital groceries and pick up their prescription before a cold weather front arrives. Two room thermometers included with the pack also help keep the bedroom and living room at an optimum 18 °C. Just six degrees under this temperature can kill a vulnerable person with COPD.