NHS in Cumbria helping people breathe easy at home

People who attend accident & emergency (A&E) with breathing problems will be more likely to avoid a hospital stay thanks to a new project being introduced in north Cumbria.

From November those who attend A&E at the Cumberland Infirmary, Carlisle (CIC) or West Cumberland Hospital, Whitehaven (WCH) with shortness of breath will be assessed using a new tool to see if they can be treated at home with more support to manage their condition.

Karen Hailes, Specialist Respiratory Nurse at Cumbria Partnership NHS Foundation Trust, said:

“For some patients it’s much better if they can stay at home. This new tool ensures that patients only leave hospital when it’s safe to do so and we have clear steps in place to support the ongoing management of their condition. It also means that we will be able to clearly see how we can support people to be treated at home; where they would prefer to be.”

Each year around 4,500 people attend north Cumbria’s A&E departments with flare ups of their lung conditions such as asthma or COPD (Chronic Obstructive Pulmonary Disease - a group of lung conditions that cause breathing difficulties). In winter the numbers increase as the change in weather can aggravate symptoms.

Half of all those who are admitted to hospital could get home sooner or even avoid a stay altogether with the right support in place. The new screening tool, known as DECAF, is used nationally to assess how likely someone is to develop complications by looking at results such as blood tests and ECGs. This standard approach allows teams to safely evaluate the risks of an early supported discharge from hospital and ensure patients are in the best place for their needs. It is also used to put a rapid treatment plan in place for those at high risk of complications.

Dr Laura Duffy, A&E Consultant at North Cumbria University Hospitals NHS Trust, said:

“This new multi-disciplinary way of working allows us to use test results we already perform to decide on the safest and most appropriate care for each patient. It also allows us to confidently discharge patients home from the Emergency Department knowing there is a safe follow up plan in place. It has been successfully used elsewhere to reduce the time that people spend in hospital so we’re excited to start using it in north Cumbria.”

Patients who do not need to be admitted into hospital will be assessed by the Home First team to identify any additional support they might need to cope at home, such as carers or equipment. Within 24 hours they will receive a home visit from community teams from the local Integrated Care Community (ICC), who will assess the patient and work with them to ensure they have the best support to manage their condition and reduce the likelihood of further flare ups.

They will then be referred to the community respiratory team who provide specialist support depending on the individual’s needs. This could include better breathing classes – activity and information sessions to help people manage their condition. These can be face to face classes or at home through innovative virtual reality technology which is now in use across Cumbria.

Yannick Raimbault, Senior Network Manager in west Cumbria, added:

“It’s really exciting to be introducing this new tool which has huge potential to improve the lives of so many people in Cumbria. We need to make sure patients are in the best place for their needs and that place is often home. If we can support them to manage their condition at home we’re not only helping them but also ensure beds are free for those who really need them.”

Hospital is the right place to be for some treatments but if a stay can be avoided patients often recover quicker in the comfort of their own home. It also makes better use of limited health and care resources which is particularly important in winter when the demands on health services increase.

Staff have received training to ensure the new way of working is applied consistently. It has now been rolled out and will be monitored to assess the impact it has on improving patient care.

Anyone who thinks they could benefit from better breathing classes, also known as pulmonary rehabilitation, should speak to their GP.

A&E is for serious and life-threatening conditions including breathing difficulties and shortness of breath. Those experiencing either of these should attend their local A&E where their condition will be assessed.