Enhanced Respiratory Assessment Service

Enhanced Respiratory Assessment Service (ERAS) is an admission avoidance service providing specialist care by the Community Integrated Respiratory Service (CIRS) for patients experiencing exacerbations of their COPD (ECOPD). In these cases patients have a sustained worsening of symptoms beyond their usual day-to-day variations and need specialist support to stay at home.

Enhanced Respiratory Assessment Service for LLR

  • Launch: 6 January 2020
  • For: Patients with exacerbation of COPD.
  • Coverage: Leicester, Leicestershire and Rutland (LLR).
  • Operation: Monday to Friday, 9.00am to 5.00pm (referrals received after 3pm will be clinically triaged the following working day).
  • Referral: SystmOne practices can e-refer and EMIS practices can refer via SPA. A PRISM form is currently in development and will be live by February 2020.

 

This is an evidenced-based ‘admission avoidance’ service for patients experiencing exacerbations of their COPD (ECOPD). Referrals into the ERAS service will be clinically triaged by a respiratory specialist.

What is the new service?

Enhanced Respiratory Assessment Service (ERAS) is an admission avoidance service providing specialist care by the Community Integrated Respiratory Service (CIRS) for patients experiencing exacerbations of their COPD (ECOPD). In these cases patients have a sustained worsening of symptoms beyond their usual day-to-day variations and need specialist support to stay at home.

Scope of the service

The ERAS service is for any patient in the community experiencing an exacerbation of COPD who the assessing clinician feels does not meet the threshold for hospital admission, but who would benefit from closer clinical (not social) monitoring by a respiratory specialist, with an aim to avoid an unnecessary hospital admission.

This service is provided in Leicester, Leicestershire and Rutland and will also provide supported discharge for patients admitted with ECOPD to reduce risk of readmission.

 

How to refer to the service

Referrals are accepted:

  • from Primary Care, DHU, EMAS and HomeFirst (LPT).
  • Monday – Friday, 9.00am to 5.00pm (excluding Bank Holidays). Referrals received by 3pm will be clinically triaged by a respiratory specialist. Referrals received after 3pm will be clinically triaged the following working day.

The Community Respiratory Team referral form must be completed and sent electronically to the LPT Single Point of Access via PRISM or e-referral on SystmOne (S1).

For services on S1 please create a share of the patient’s record.

For services NOT on S1 please attach a copy of the patient’s spirometry and a copy of current medications and record of past medical history. Alternatively, a telephone referral will be accepted by telephoning the LPT Single Point of Access on 0300 300 1000.

Once the referral has been received, the patient will be telephoned the same day, if received after 3pm they may not be triaged until the next working day. An appointment will be offered for review on the next working day (if not a Friday) if the referral is appropriate.

Patients who have previously been under the care of ERAS can self-refer into the ERAS service by using the contact number documented on their Self-management Plan.

  • This is not an emergency service. If a patient is at risk of admission/readmission into hospital and needs an urgent response, please consider other urgent care provision
  • Patients will be supported up to Day 14 from the date of referral.
  • Ongoing clinical support after this time will be re-assessed and referred on to appropriate service(s) or discharged from the ERAS back to the care of their GP.

Referral criteria

  • The patient’s main diagnosis is an exacerbation of COPD (ECOPD) and they need specialist respiratory clinical support to stay at home.
  • Confirmed diagnosis of COPD. Please enclose most recent spirometry (essential for primary care referrals).
  • Patient is able to cope at home and is well supported.
  • Significant co-morbidities stable.

Criteria exclusion

Unable to cope at home. Significant co-morbidity Acute LVF/CCF Pneumonia New and undiagnosed chest/cardiac condition Confused, agitated patients Main diagnosis is not COPD e.g. bronchiectasis, interstitial lung disease, asthma, lung cancer.

How to access this service

How to refer to the service

Referrals are accepted:

  • from GPs, Paramedics, LPT’s community nursing teams, and the night service GPs and community nurses;
  • Monday – Friday, 9.00am to 5.00pm (excluding Bank Holidays). Referrals received by 3pm will be clinically triaged by a respiratory specialist. Referrals received after 3pm will be clinically triaged the following working day.

Patients who have previously been under the care of ERAS can self-refer into the ERAS service by using the contact number documented on their Self-management Plan.

  • This is not an emergency service. If a patient is at risk of admission/readmission into hospital and needs an urgent response, please consider other urgent care provision
  • Patients will be supported for up to two weeks from the date of their referral.
  • Ongoing clinical support after this time will be re-assessed and referred on to appropriate service(s) or discharged from the ERAS back to the care of their GP.

What conditions do you cover

Patients with exacerbation of COPD.

Contact info

0116 225 6000