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Respiratory Services

Introduction

The respiratory service is currently offered for adults in Birmingham East and North and Central and West who are diagnosed with one or more condition that causes breathing difficulties. Treatment and advice is provided in clinics and in the community, depending on individual service users’ needs.

The Respiratory Admission Avoidance and Assisted Discharge Service is available for North, East, Central and West Birmingham adult patients aged 35 or over who have a confirmed diagnosis of COPD, Chronic Asthma or Bronchiectasis. 

For Central and West Birmingham primary care respiratory clinic is led by a GP with Specialist Interest (GPWSi), which offers patients aged 18 years and over who have a suspected or confirmed diagnosis of COPD, Asthma or Bronchiectasis. Whereas the East and North offers a Nurse Led COPD Clinic, for patients aged 35 and over who have suspected or confirmed diagnosis of COPD.

The Pulmonary rehabilitation programme is offered to Central and West Birmingham adult patients aged 35 years and over who have a suspected or confirmed diagnosis of COPD, Asthma, Bronchiectasis and Interstitial Lung Disease (ILD)

“For patients with a South Birmingham GP, the GP will advise of the appropriate referral pathway e.g. Community nursing or University Hospital Birmingham”.

“We currently do not provide an oxygen service; please refer to Secondary care for assessment and on-going treatment”


Who Delivers it?

The Service is delivered by MDT of Nurses, Physiotherapists,  Assistant Practitioner and HCSWs based at Lansdowne Health Centre, Winson Green.

The GPWSi Clinics are delivered at Greet Health Centre and Soho Health Centre, while the Nurse Led Clinics are delivered at Richmond Health Centre and Dove Medical Practice.

The Pulmonary Rehabilitation classes are delivered at St Johns Church (Sparkhill) and Panel Croft Village (Lozells).


The  Service Referral Criteria

Referrals accepted from:

  • Secondary Care A&E and  Inpatients departments
  • General Practitioners
  • Self-referrals by patient if previously known to the Service
  • Patients identified by Practice Nurses, Intermediate Care Team, Community Nurses,
  • Physiotherapists and other community sources with the agreement of the GP


Information for Carers / family members

  • A referral needs to be made by a healthcare professional
  • For initial support, your GP/Practice Nurse or District Nurse should be contacted if not already known to Respiratory Nurse.

For professionals

  • Referrals are made by fax for AA/AD, Pulmonary Rehab and Nurse led clinic.
  • Referrals are made by fax or electronically for GPWSi clinics
  • Joint visits may be undertaken with other health care professionals as necessary”


Admission Avoidance and Assisted Discharge (AA/AD)

The Admission Avoidance and Assisted Discharge Service provides access for adults with chronic asthma, COPD and bronchiectasis to deliver active care management when their condition is unstable, delivered within the patient’s home environment by a specialist multi- disciplinary team. Furthermore, the service can support reductions in length of hospital stay using in-reach strategies. 

The Admission Avoidance & Assisted Discharge Service should accept referrals for patients aged 35 years and above with the following conditions:

•Chronic Obstructive Pulmonary Disease (COPD)

•Bronchiectasis

•Chronic Asthma

The high-level key objectives of the service are:

•to provide specialist care to adults of 35 years or over with unstable episodes of COPD, chronic asthma and bronchiectasis using a multidisciplinary approach

•to prevent hospital admissions and reduce the length of hospital stay using both ‘in reach’ and ‘outreach’ strategies

•To prevent hospital readmissions within 28 days of discharge

•to ensure prompt, optimal management and integrated care for all patients in line with evidence-based guidance, providing:

oexpert care in the community when appropriate

oadmission to hospital when required

oearly, structured and assisted discharge of patients with COPD, chronic asthma or bronchiectasis when appropriate

•to ensure effective management of co-morbidities, optimisation of therapy and smoking cessation as appropriate.

•to support patients within their home to prevent hospital admission or facilitate discharge following a hospital admission

•to minimise the impact of the disease (through faster and more effective treatment of exacerbations and fewer hospital admissions and re-admissions)

•to improve symptom control, function and quality of life for all patients with the disease

•to ensure effective communication with the patient and support for self-management

•to co-ordinate with all disciplines across the care pathway to ensure integration and effective communication with GP services, secondary care providers and social services as appropriate 

•To provide specialist support, when required, to patients in the end stages of their chronic respiratory condition



Primary Care Clinics

  • The GPWSi Clinic will accept referrals for adult patients where there is suspected and uncertain diagnosis of Asthma, COPD and Bronchiectasis whereas the Nurse Led clinic will accept referrals with suspected and uncertain diagnosis of COPD.
  • Poorly controlled or unstable Asthma or COPD
  • Frequent exacerbations or intolerance to medications
  • Patients complaining of cough or breathlessness with suspected respiratory care
  • Assessment to optimise treatment i.e. Long term nebuliser trial.

 

Exclusions Criteria

  • Suspected Cancer
  • Suspected TB patients
  • Haemoptysis
  • Acute, abnormal changes on CXR
  • Patients already under the care of a respiratory physician
  • Patients under age 18 for GPWSi Clinics and under age of 35 for Nurse led clinics.


Pulmonary Rehabilitation Service

  • Patients with confirmed diagnosis of COPD by Spirometry, Asthma, Bronchiectasis and (ILD) with an MRC score of 3 and above.
  • Patients with an MRC score of 2 who are symptomatic and disabled by their condition and who require health care professional assessment and supervision of exercise training, rather than simple advice on lifestyle changes.
  • All patients who consider themselves functionally disabled by breathlessness.
  • Age 35 years and above.

 

Exclusions Criteria

  • No recent Cardiac history
  • No Musculoskeletal/Neurological limiting factors

“Transport may be provided in certain circumstances”.

 


Contact Us

Admission Avoidance and Assisted Discharge team - 0121 245 5707

Respiratory Clinic - 0121 245 5708

Pulmonary Rehabilitation -  0121 245 5708

Fax number – 0121 245 5711