Community Respiratory Liaison Service
Dr Hans Hartung, Consultant Respiratory Physician
Dr David Sword, Consultant Respiratory Physician
Dr Robert Balfour, GP
Dr Kenneth Brooksbank, GP
Elizabeth Anderson, Practice Development Nurse (Respiratory)
Alison Anderson, Respiratory Managed Clinical Network Manager
Evaluation Results
Evaluation Results
Uptake by Practices
Uptake
by review
Practices
To date
meetings have been held with 31 General Practices (56% of Ayrshire &
ToArran
date review
meetings have been held with 31 General Practices (56% of Ayrshire &
Practices)
Arran Practices)
Comparison of unscheduled hospital respiratory admissions and associated bed
Comparison
hospital
respiratory
admissions
and associated bed
days in theof12unscheduled
months before
and 12
following the
review meeting
days
in the 12data
months
before available
and 12 following
the review
meeting
Evaluation
is currently
for 7 General
Practices
(26 patients). Evaluation
Evaluation
data
is currently aavailable
forof7 32
General
Practices
(26 patients).
Evaluation
of the data
demonstrates
reduction
hospital
admissions
and 238 bed
days
of the data demonstrates a reduction of 32 hospital admissions and 238 bed days
Effective
Aim
Unscheduled Hospital Admissions
Unscheduled Hospital Admissions
Unscheduled Hospital Admissions
Methodology
9
8
7
6
5
4
3
2
1
9
8
7
6
5
Respiratory related hospital
Respiratory related hospital
admissions in 12 months
admissions in 12 months
before casenote meeting
before casenote meeting
Respiratory related hospital
Respiratory related hospital
admissions in 12 months
admissions in 12 months
after casenote meeting
after casenote meeting
4
3
2
1
0 0
9 11
10 12
11 13
1214
1315
1416
1517
1618
1719
1820
1921
2022
2123
2224
2325242625 26
1 21 32 43 54 65 76 87 98 10
PatientID
Patient
ID
PatientID
Associated
Days
Associated
BedBed
Days
Associated Bed Days
Respiratory Specialists review identified patients’
hospital notes prior to the meeting.




Multidisciplinary review meeting held, involving the
Practice team, including District Nurses and Social
Workers, where relevant.
Action plans developed for each patient.
Resources and services available to support respiratory
patients in the community promoted.
Results
Uptake by Practices
To date review meetings have been held with 31 General
Practices (56% of Ayrshire & Arran Practices)
Comparison of unscheduled hospital respiratory
admissions before and after the review meeting
Evaluation data is currently available for 7 General
Practices (26 patients). Evaluation of the data
demonstrates a reduction of 32 hospital admissions and
238 bed days
12 months before
12 months after
casenote review meeting casenote review meeting
Number of Total
patients
hospital
admissions
72
Total
bed-days
621
Total
hospital
admissions
40
Total
bed-days
383
In-Patient
12 months
120120 In-Patient
DaysDays
in 12inmonths
before
casenote
review
meeting
before
casenote
review
meeting
In-Patient
12 months
DaysDays
in 12inmonths
100100 In-Patient
after
casenote
review
meeting
after
casenote
review
meeting
Totalnumber
number of
days
Total
ofbed
bed
days
Total number of bed days
General Practices invited to set up a casenote review
meeting with Respiratory Specialists to discuss a
maximum of 6 respiratory patients most at risk of
emergency admission.
26
10
Total number
Number ofofAdmissions
Total
admissions
Total Number of Admissions
NHS Ayrshire & Arran has above average prevalence
of respiratory conditions that account for a large
percentage of emergency hospital admissions.
This initiative provides respiratory specialist input to
General Practices to help reduce unscheduled respiratory
hospital admissions and helps increase knowledge
and confidence in primary care teams to support more
complex patients at home.
10
80 80
60 60
40 40
20 20
0 0
9 11
10 12
11 13
12 14
1315
1416
1517
1618
1719
1820
1921
2022
2123
22242325242625 26
1 21 32 43 54 65 76 87 98 10
Patient
Patient
Patient
IDID ID
Please
submit
your
completed
abstract
form
to your
poster
co-ordinator:
Please
submit
your
completed
abstract
form
to your
poster
co-ordinator:
Other reported benefits
[email protected]
[email protected]
Update on
latest thinking on
prescribing useful
Advice/guidance
on asymptomatic
patients helpful
Increased input from
District Nursing teams
very welcome
Increased knowledge
of guidelines/services/
resources/new initiatives
Good opportunity to
build relationships
Advice on specific
(complex) patients
particularly useful
Has helped develop
anticipatory care plans
Reported
Benefits
Interest in ongoing
opportunities for
discussion & education
Conclusion
As well as reporting reductions in emergency admissions
and bed days for the selected patients, evaluation
highlights potential for sooner discharge to GP care and
provision of safe and effective care for patients at home.
This approach has demonstrated enhanced relationships
between primary and secondary care teams and
opportunities for increasing Respiratory knowledge of
primary care teams.
Data will continue to be gathered for the remaining
Practices to enable further evaluation of impact.
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