Extra help for those with severe breathing difficulties

Posted on in Community services, Hospitals, Services

With an increasing number of respiratory cases being seen at The James Cook University Hospital in Middlesbrough, a three-month pilot has begun promoting the acute respiratory assessment service.

The acute respiratory assessment service team

The team from left to right: Nikki Craggs, chest physiotherapist; Dr George Antunes, consultant chest physician; Halina Baker, chest physiotherapist; Dr Rehan Mustafa, consultant respiratory medecine; Dr Ramamurthy Sathyamurthy, consultant chest physician and Dr Natarajan Krishnaraj, consultant chest physician.

It is being actively promoted to GPs, nurse practitioners, community matrons as well as to patients across South Tees and provides a fast-track to diagnosis or care plan for people with severe breathing disorders. It is seen as another positive step within the ‘improving patient pathways’ programme.

This new service is aimed mainly at patients with chronic obstructive pulmonary disease (COPD), asthma and bronchiectasis but planning is underway to make this service available for patients with other long-term respiratory conditions.

By providing a proactive assessment service, it will allow clinicians an opportunity to capture patients at a stage where they are not seriously ill enough to warrant hospital admission, although for some, admission may be the only answer.

Experience shows that in the majority of cases early diagnosis and ensuing care plans, and rescue packs in emergencies, will help to alleviate a patient’s condition and provide a much improved level of care.  Hospital admissions are expected to reduce as a result.

Assessments can be arranged through a GP, community matron or nurse or through the hospital.

Dr Rehan Mustafa, consultant respiratory physician at The James Cook University Hospital, along with his colleagues Dr Ramamurthy Sathyamurthy and Dr George Antunes have been working closely with Dr Nigel Rowell from South Tees clinical commission group to set up this service.

Dr Rehan Mustafa, who is leading on the introduction of the service said “About 60% of hospital patients in our catchment area are admitted to the hospital with a respiratory disorder and the vast majority of cases have chronic obstructive pulmonary disease.”

He added: “Those patients could be treated just as well at home, as in hospital, so this new assessment service is a ‘win-win’ situation for both patients and the NHS. Patients will be assessed by a consultant physician and investigations, such as chest radiograph, arterial blood gases and spirometry, will be performed when needed. A chest physiotherapist will also be available to go through inhaler techniques and management of breathing.”

Likely benefits arising from the service are:

  • the creation of treatment plans for patients where none have existed before;
  • to make the best of treatment plans;
  • to make the best of inhaler techniques and chest physiotherapy, and referral to the pulmonary rehab service;
  • helping patients to avoid un-necessary hospital admissions by administering intravenous antibiotics to patients at home, where they are needed to help stabilise their condition;
  • being able to link the new service to palliative care for the most severe cases.

If the service proves successful, the long term vision is for patients to be able to self-refer to a specialist COPD nurse at the hospital or in the community, using a designated hotline.