Right People at Right Time: An Innovative Approach to ILD Management

Dr Ruth Williams, ILD Clinical Lead / Respiratory Consultant

Natalie Murray, ILD Clinical Nurse Specialist

Joanne Wheeldon, Specialist Respiratory Pharmacist

Rebecca Griffiths, Respiratory Physiologist


Cwm Taf Morgannwg University Health Board

Hospital staff sat in office


The Interstitial Lung Diseases (ILD) are a diverse group of conditions that may be progressive and ultimately fatal. Therefore, timely access to specialist care, diagnostics and appropriate support during the course of the illness is crucial. This is certainly true for one particular condition, Idiopathic Pulmonary Fibrosis (IPF). IPF is an incurable and progressive lung condition and the current mean survival is 2.5-3.5 years following diagnosis. We propose delivering a new model of service for our patients, utilising the expertise of a number of allied health professionals to deliver high quality, evidence-based healthcare in a timely manner.

Chest x-ray

Project Aims

One of the primary aims of this project was the development of the pharmacy-led service. By utilising the skills of a prescribing pharmacist it would reduce consultant and specialist nurse work load, reducing waiting times and provide access to a specialist prescriber.

Another facet of this project was the innovative physiology-led (P-ILD) service. At this one-stop review patients with stable disease would receive their lung function test and clinical review by our physiologist – saving multiple appointments.


Patient-Centred Aims

Service Improvement Aims


Key Outcomes


Time to first appointment and diagnosis was significant reduced through a combination of service improvements from January 2019 (including the MDT approach to follow up) for our IPF cohort.

Bar chart showing median time referral to diagnosis

Our pharmacist-led clinics were only operational (due to challenges discussed) over a 2 month period and in that time 29 patients were reviewed.

100% of patient had lifestyle factors, compliance and side effects discussed. 97% of patients had their medicines reconciled and as a result there were interventions made in 43%. As well as experience outcomes, this service also ensures safety for our cohort on toxic therapies.

Our pharmacy –led service was very well received by patients, with 75% agreeing they were happy to see a pharmacist instead of a nurse or doctor.

Service Outcomes

Patient Quotes

Patients and staff

“The one stop shop approach adopted by POW has enabled great transparency for both patient and staff. As a patient it gave me complete confidence”.
“ Patient care at POW has always been outstanding, but new inter department structure and practices have given even greater benefit to the patient”.
“Being able to talk, meet professionals across hospital departments just got easier. Great news for the patient”.

Patient quotes

Next Steps

Our Exemplar Experience

We have found the Bevan experience to be inspiring and a positive encouragement to persevere with innovation.

Bevan Exemplar Showcase 2021