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NHS@home - Respiratory pathway

Checked: 23-11-2023 by Vicky Ryan Next Review: 23-11-2024

Overview

The NHS@Home Respiratory team provides clinical care for people who are acutely unwell with a respiratory illness (new or exacerbation of a chronic condition) in their own homes across BNSSG.

Who are we? Advanced Clinical Practitioners specialising in respiratory disease, multidisciplinary healthcare professionals from the collaborative BNSSG NHS@Home team, working with Specialist Consultants from NBT and UHBW.

How does the service work?

The service uses a mixture of digital remote monitoring up to four times per day (NEWS2 and bespoke questionnaires) visible on a virtual ward dashboard, telephone and video support, and face to face visits from specialist teams.

The service user needs to be adequately safety netted to remain at home until the respiratory team can complete an assessment. As usual practice, please commence urgent medication for acute respiratory presentation. If the service user requires IV antibiotics, please contact us via the clinical advice line below, as we can look to support this pathway alongside the service.

What enhanced skills does the service provide?

Management of nebuliser therapy, weaning and monitoring of respiratory medication to ensure efficacy.
Airway clearance.
Access to respiratory consultants

Who is suitable for an NHS@Home Respiratory pathway of care?

The service is suitable for adults who:	This service is not suitable for adults who:
Meet the general criteria for an NHS@Home pathway Are acutely unwell with a respiratory illness (new or exacerbation of a chronic respiratory condition) including: Exacerbation of COPD. Exacerbation asthma Lower respiratory tract infection. Mild pneumonia (CURB<2).	Have an acute cardiac condition. Have an acute pulmonary embolism. Are pregnant or 6 weeks partum. Have asthma PEF <50% or variability response greater than 25% pre and post nebuliser. hHve acute confusion or drowsiness. Are breathless to the extent they cannot complete full sentences.

Referral

In addition to the pathway specific criteria above, the standard criteria on the NHS@Home overview page need to be met.

To refer to this service, please refer to the NHS@Home overview page.

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.

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