Integrated Respiratory Service
Aims and objectives of service
This service cares for patients who have a suspected or confirmed diagnosis of respiratory disease, including Chronic Obstructive Pulmonary Disease (COPD), asthma and bronchiectasis and other confirmed chronic respiratory illness such as pulmonary fibrosis.
The service aims to monitor and manage patients to prevent further deterioration and complications. It also aims to provide education and support in the community that prevents admission to hospital and reduces the length of any hospital stays.
Patients are managed and treated according to the severity of their disease.
Patients with a respiratory condition that are stable will be managed by their GP. Patients who have difficulties with their respiratory conditions can be referred directly to the Rapid Response Respiratory Service (RRRS) for further management of their condition.
Patients can also be referred directly for a course of pulmonary rehabilitation if required. Patients who are not stable and require rapid assessment will be referred to the Nottingham University Hospital NHS Trust (NUH) Respiratory Assessment Unit (RAU).
A pink card is also available. This is a way of directing ambulances directly to the NUH RAU where patients in distress are seen by the respiratory team. Referral for the Pink Card is initiated by the GP and or Community Matron or RRR service.
Patients whose condition is serious but stable are referred to the RRRS. Intensive assessment, close monitoring and proactive management of the patient’s condition will be provided in order to prevent further deterioration. Patients are treated effectively and discharged after a maximum period of three weeks, extended only after discussion with consultant advice. If after a maximum of three weeks patients are still not stable, an onward referral or discussion with a secondary care consultant may be appropriate, or they will be discharged back to their GP.
Patients who have been managed by RRRS are referred to the Respiratory Education Advice and Diagnostic Service (READS) team to receive more information and advice about their disease. A care plan will be initiated or reviewed and pulmonary rehabilitation will be offered as well as spirometry testing and interpretation. Referrals are accepted via the RRRS team, specialist community team or directly from a GP as well as the NUH RAU.
Patients who are diagnosed as unstable will be referred to the NUH RAU unit. Once the patient is stabilised, early supported discharge to the RRRS or READS may be appropriate. If this isn’t required the patient is discharged back to their GP.
Discharge Communication Co-ordinators ensure that patients are well informed of the services available to them on discharge from hospital to reduce re-admission rates.
The Integrated Respiratory team provides support for patients on Long Term Oxygen Therapy (LTOT) as well as Ambulatory Oxygen.
Referrals will be accepted as follows:
- Respiratory Rapid Response Service (RRRS):Referrals will be accepted from GPs, Community Matrons, Community Nursing teams and NUH.
- Respiratory Education Advice & Diagnostic Service (READS):Referrals will be accepted from GPs, Community Matrons, Community Nursing teams and NUH.
- Respiratory Assessment Unit - NUH:Referrals will be accepted via NEMS and the Pink Card navigation system and via the RRRS.
When is this service offered?
The service is available 7 days a week, 365 days a year from 8.00am to 7.00pm.
The service will provide support to patients aged 18 years and over and who are registered with a NHS Nottingham City Clinical Commissioning Group GP.