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ARNS Respiratory Team of the Month April 2024 – Knowsley community respiratory service (KCRS) at Liverpool Heart and Chest Hospital NHS Trust (LHCH)

Congratulations to the April winners of ARNS Respiratory Team of the Month – Knowsley community respiratory service (KCRS) at Liverpool Heart and Chest Hospital NHS Trust (LHCH).

KCRS supports the management of patients in the community 24/7 with respiratory conditions. A key service element is admission avoidance and LHCH nurses are based in the local DGHs to help facilitate this. The introduction of the ‘SWISS nurse’ (review all patients irrespective of ICB) pilot in December 2018 had a significant impact on the numbers of patients being discharged early and with additional funding, this has been continued each Winter since. The team have also collaborated with the Northwest Ambulance Service to provide a rapid response respiratory car, again with the aim of reducing non-elective hospital admissions. During COVID19 pandemic the service was responsive and in January 2021 saved over 600 bed days with the introduction of the Covid Virtual Ward for patients discharged form Whiston Hospital. In addition, the SWISS nurse and KCRS were one of the first pilot sites for virtual wards nationally. Due to the success similar models of work have been rolled out across Cheshire and Merseyside.

The other service elements are briefly listed below

Rapid Response
This element of the service operates 24 hours per day, 7 days per week, 365 days of the year offering advice, support and domiciliary visits to patients who need urgent respiratory care with the aim of keeping them safely at home.

Home Oxygen – Assessment and Review – Service
The team provide assessments, as well as ongoing oxygen management either at home or in one of the community venues, for both Liverpool and Knowsley residents.

Community Respiratory Clinics
These Consultant Led clinics are delivered as a hybrid approach virtually and face to face. There are be clinics in various locations in Knowsley offering a full MDT approach but at least 30% of clinics will remain virtual. The Community Clinics are now fully using EMIS.

Physician Associates (PA’s) and Physician Associate Assistant Practitioners (PAAPs)
This element of the workforce was employed to support primary care in the long-term management and optimisation of COPD patients. From December to March, the Physician Associates were based in the A&Es across Cheshire and Merseyside supporting winter pressures. This workforce was invaluable during the Covid 19 response, supported CVW, completing shifts in Rapid Response and Early Supported Discharge.

Pulmonary Rehabilitation Team & Community Physiotherapy
Providing pulmonary rehabilitation and community respiratory physiotherapy – staffing is adequate to provide this. Pulmonary rehab has embraced the digital support platforms and supported many patients with their rehab needs. The recruitment of physiotherapists has proved difficulty in the last 12 months therefore the role has been changed to specialist practitioner role opening up the scope for respiratory specialist, to apply we have been successful with this change in staffing workforce and have our first Paramedic practitioner which brings new set of skills to the service.

Diagnostic and Annual Spirometry, Diagnostic Sleep and Asthma Feno Testing
Covid 19 pandemic required that all aerosol generating procedures were paused and only recommenced with a full risk assessment in place. Clinics are delivered by pulmonary function team in community venues and at Liverpool Heart & Chest Hospital.

Symptom Control and Management (Palliative Care)
Providing specialist respiratory palliative care is essential in the long-term management of chronic respiratory disease. The service is led by a Respiratory Physiotherapist.

ARNS are open to nominations for ‘Respiratory Team of the Month’ from ARNS members. The winner of ‘Respiratory Team of the Month’ will appear in our monthly e-shot bulletin and on our social media channels.

In order to nominate your team, please complete the online form here. Nominations for entries for May will close on 15th May 2024.

ARNS Respiratory Team of the Month April 2024 – Knowsley community respiratory service (KCRS) at Liverpool Heart and Chest Hospital NHS Trust (LHCH)