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HOT Clinics (Respiratory)

Checked: 13-02-2024 by 3 Vicky Ryan Next Review: 12-02-2025

Service Overview - NBT

The Respiratory Hot Clinic at NBT is an admission prevention clinic for respiratory patients. Once a referral is made, the patient will be seen within 24 hours on a same day/next day service.  They will be seen by the Hot Clinic Facilitator and Respiratory physician in clinic and, if possible, be discharged back to the community within the same day.  The service is supported by Respiratory Specialist Nurses who provide home support during the patient's acute illness.

The service runs from Gate 12 on the Southmead Site from 08:00- 17:00 hrs. Referrals received where patient is able to arrive by 14.30pm will be seen the same day, otherwise next day service. 

Please note, the hot clinic is not a ‘walk-in’ service.  Patients will be booked and seen strictly on an appointment basis only. Patients must be advised to attend only once they have been contacted by the hot clinic team, which may not be on the same day as being seen in the community. 

Please see the Advice & Guidance - Respiratory page of Remedy for telephone respiratory advice.

Please consider if NHS@home Respiratory pathway may be more appropriate.

Referral Guidance - NBT

Inclusion Criteria:

  • Emailed referral from a community health care professional for patient threatening admission with a respiratory cause 

  • Patient must be available to be seen within 24 hours of referral

  • For exacerbations of COPD or asthma, we would expect that the patient had at least been given a trial of steroids/antibiotics first in primary care; i.e. in the last 2 weeks..

Exclusion Criteria:

  • Suspected lung cancer in well patient to be referred via '2-week wait, fast track' 

  • Patients who cannot attend within 24 hours

  • Patients who are referred on a Friday and cannot be seen the same day will be put back in the care of the referring health care professional.  They can be advised to either admit or re-refer the next week if still concerned about the patient's condition

Referral forms (word doc) should be emailed to Please make sure that you include list of medications, allergies and past medical history with every referral. Include [secure] as the first word on the "subject" line as this is not an email. The service runs Monday to Friday excluding bank holidays. Please ensure the patient's contact telephone number is included in the referral form. They will be contacted by phone to give them an appointment time.

Referrals received where patient is able to arrive by 14.30pm will be seen the same day otherwise next day service.

Referrals will be screened by a Specialist Respiratory Nurse or Respiratory Physician prior to accepting/declining.  Where patients cannot be seen, the referring health care professional will be informed and the responsibility of care taken back by them. 

Service Overview - UHBW

The urgent respiratory assessment (Hot) clinic at UHBW has been set up to provide rapid assessment for any adult patient with acute respiratory symptoms who is threatening admission.

When: Monday - Friday 9.00am - 12:30pm

Where: Respiratory Outpatients, A221, Queens Building, Bristol Royal Infirmary

Aim of the service is to see patients within 48 hours of referral but exact wait times may fluctuate during busy periods. Capacity for this emergency/admission avoidance clinic is limited and appointments may have to prioritised. 

Please consider if NHS@home Respiratory pathway may be more appropriate.

Referral Guidance - UHBW

Update 19/03/2024: Limited capacity at the Respiratory HOT clinic at the BRI is currently being reviewed as a service but waiting times are likely to be longer than normal

The service is still open to appropriate referrals, but the waiting times are likely to be in the region of 1-2 weeks. Please consider prescribing further medication given the delay. This will be mitigated by a robust triage of referrals, ensuring that they are managed appropriately according to clinical priority.

Inclusion Criteria

  • Any adult patient with acute respiratory symptoms who is threatening admission

Exclusion criteria:

Referrals should be made via eRS to the Respiratory HOT Clinic RAS using the Hot Clinic Referral Form (word doc).  All referrals will be clinically triaged and a suitable appointment offered. 

Patients with Weston area postcodes can be managed within UHBW but will need to travel to Bristol.

Please ensure patient contact telephone number is includedWe will contact them by phone to give an appointment time.

For further advice or information please contact the Respiratory Nurse Specialists on telephone number 0117 3424101


Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.