There are approximately one million people living with heart failure (HF) in the UK.¹ This situation is particularly acute in Glasgow, which has one of the highest rates of coronary heart disease in the world and 5,000 patients waiting for echocardiography, which is necessary to diagnose HF.² With this in mind, we partnered with NHS Greater Glasgow and Clyde, the West of Scotland Innovation Hub, the University of Glasgow, and other organisations to optimise a digital diagnostic pathway for HF in the community – Project OPERA.

OPERA investigators re-designed the local community pathway to maximise operational efficiencies, introducing active clinical referral triage (ACRT). All patients on the HF diagnostic waiting list were invited to a diagnostic investigation, with consenting participants receiving a point of care (POC) echocardiogram and additional blood tests.

Since the launch of the project in January 2021, more than 700 people have taken part in the study and benefitted from the significant improvements in the diagnostic pathway for HF. For example, waiting lists for echocardiograms have reduced from 12 months to four weeks. The outcomes of this project will validate a new model of care that will harness artificial intelligence (AI) and machine learning, to improve access to HF diagnostics in the community.

Project Opera forms part of a Memorandum of Understanding (MoU) with the NHS Golden Jubilee’s National Centre for Sustainable Delivery, NHS Greater Glasgow & Clyde, University of Glasgow, and Lenus Health, which is aimed at improving population health and transforming patient outcomes by scaling practice change across care settings in line with Scottish Government and NHS Scotland priorities.

Over-reliance on short-acting beta antagonist (SABA) inhalers increases the risk of severe asthma exacerbations and is a common problem in the UK.³ Hull Clinical Commissioning Group (CCG) adult emergency hospital admissions prior to SENTINEL implementation (2017/18 and 2018/19) were the highest across all CCGs in the Humber coast and Vale STP.⁴

Working with Hull York Medical School, Hull University Teaching Hospital and Hull CCG we launched the SENTINEL Project to implement a maintenance and reliever therapy (MART) dry powder inhaler (DPI) preference asthma guideline in a primary care setting.

Following implementation of the SENTINEL Project, SABA inhaler prescribing has significantly reduced, which not only has helped participating patients, but also has helped to reduce the environmental impact of SABA inhalers issued across the six primary care networks (PCN) involved in the project.

Following the successful pilot in Hull, we are now supporting roll out to over 300 PCNs, health boards and federations across the UK, via a donated goods and service through the SENTINEL Plus initiative.