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RIPPLE: Respiratory Innovation Promoting a Positive Life Experience


The Health Foundation

NHS Regional Innovation Fund (West Midlands)




University Hospitals Coventry and Warwickshire

Project team

Dr Alan Taylor, School of Health

Dr Nicole Steils, CCSJ

Dr Louise Sewell, School of Health

Joy Monkhouse, School of Art and Design

Project objectives

The RIPPLE project applied an asset-based community development approach to improve wellbeing and reduce the high levels of anxiety and social isolation observed in individuals with severe Chronic Obstructive Pulmonary Disease (COPD) in Coventry.

We were engaged to undertake an evaluation of this complex, innovative project  against its original intentions which were as follows:

  • Improved social inclusion;
  • Better Patient engagement;
  • Increased Patient wellbeing;
  • Better self-management;
  • Reduction in hospital admissions and health care utilisation;
  • Improved NHS engagement with hard to reach communities;
  • Increased NHS engagement with the Third Sector;
  • Evolving community partnerships.

Impact Statement

A whole system approach was taken. A partnership was set up involving patients and carers, primary and secondary care clinicians, chaplains, academics, public health, and third sector organisations to develop innovative solutions to the social isolation and anxiety we had observed in individuals with COPD. This led to an asset-based community development approach where we matched individual patients to existing community assets such as painting classes or fishing clubs. However, the high levels of anxiety and low self-esteem observed in our client group hampered this model.

Patient-led systemic inquiry led to the establishment of an informal community-based clinic with social activities such as bingo, quizzes, singing and seated yoga every Monday afternoon in a community centre.


  • Reduced social isolation;
  • Reduced anxiety;
  • Increased mental wellbeing;
  • Transformation change in individual lives as evidenced by personal stories;
  • Improved confidence in ability to self-manage;
  • Preliminary evidence of a reduction in unplanned admissions;
  • An innovative and integrated model of service.

Lessons Learnt:

  • Integration of health care and social activities has delivered transformational change;
  • Significant cultural and organisational differences between NHS and third sector organisations can be overcome with creativity, trust, and compassion;
  • The support of senior management at an early stage for innovative projects is essential.

See also the related project Making Waves: RIPPLE 2

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