Exploring the role and implementation of Acute Respiratory Infection (ARI) Hubs in England: a qualitative study

Conference:

SAPC ASM 2024 - Bristol

Talk Code:

1A.5

Presenter:

Aleksandra Borek

Co-authors:

Sarah Tonkin-Crine, Gail Hayward, Margaret Glogowska, Chris Butler, Sarah Walker, Matt Inada-Kim, Nick Francis, Monsey McLeod

Author institutions:

University of Oxford (AB, STC, GH, MG, CB, SW), Royal Hampshire County Hospital & NHS England (MIK), University of Southampton (NF), NHS England & NHS Improvement (MM)

Problem

Acute respiratory infections (ARIs) pose significant challenges to healthcare services, leading to surges in general practitioner (GP) and Accident & Emergency (A&E) appointments, thus straining resources and impeding patient access. ARI hubs have emerged as a potential solution, aiming to provide timely care for ARI patients while alleviating pressures on other healthcare services.In January 2023, over 300 ARI hubs were rapidly established across England, with nearly 100 reopening in November 2023 and more reopening later this winter. This signals a significant change in healthcare service provision for ARIs. Understanding the role and implementation of these hubs is crucial for informing future healthcare strategies and optimizing ARI management within communities.

Approach

This is a qualitative study. We have recruited professionals through the NHS ARI Hub Community of Practice (CoP) network, purposefully sampling to capture diverse perspectices from various hubs, locations and roles. Remote semi-structured interviews explore the experiences of setting up and working in the hubs, views on the role of hubs, perceived impacts on patients and healthcare services, and suggestions for improvements. Interviews are audio-recorded, transcribed and analysed thematically. This is complemented by the examination of NHS CoP presentations and reports to provide a broader context of ARI hub implementation in England. Patient and Public Involvement contributors have been involved throughout the study.

Findings

Initial interviews with nine professionals about last winter’s ARI hubs highlight the perceived important role of ARI hubs in augmenting healthcare system capacity and facilitating prompt, in-person assessments during seasonal surges. Hubs were established rapidly last winter through varied models, yet encountered challenges such as inadequate pre-planning, lack of sustainable funding, estate acquisition, workforce recruitment, and service integration. However, leveraging previous service models, fostering trust-based collaborations, and adaptive responsiveness to local demands emerged as key facilitators. Ongoing interviews aim to further elucidate views on and experiences of this year's ARI hub implementation.

Consequences

ARI hubs are perceived to hold promise to mitigate seasonal healthcare pressures. Effective planning, leveraging existing infrastructure, and fostering collaborative networks are essential for the timely establishment of ARI hubs to address evolving infectious disease challenges.

Submitted by:

Aleksandra Borek

Funding acknowledgement:

The study is funded by the NIHR School for Primary Care Research, with support from the NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance.