The Respiratory Team is a multidisciplinary group dedicated to the care of patients with challenging or poorly controlled respiratory conditions. 

The team consists of: 

• Respiratory Clinical Nurse Specialists 
• Senior Respiratory Specialist Physiotherapists 
• Respiratory Nurse and Physiotherapists 
• Associate Practitioners 
• Physiotherapy Assistants 

Working collaboratively, we provide comprehensive support aimed at improving patient outcomes and quality of life. Our key areas of focus include: 

• Optimisation of medication regimens
• Non-pharmacological symptom management 
• Advanced care planning and palliative support 
• Expectation setting and holistic patient education 

By delivering personalised, evidence-based care, we help patients better manage their respiratory conditions and navigate the complexities of their treatment journey. 

Pulmonary Rehabilitation is an exercise and education programme for people with lung disease who experience breathlessness. The NELFT team provides this service for patients with COPD, bronchiectasis, and interstitial lung disease.

The aim of the programme is to improve daily function and management of symptoms associated with lung disease. 

Pulmonary Rehabilitation helps to: 

• Increase walking distance 
• Reduce breathlessness and fatigue 
• Enhance Quality of Life
• Improve self-management 
• Reduce flare-ups of symptoms 
• Reduce hospital and GP visits 

Sessions are twice a week for six weeks, in various locations and run by qualified nurses, physiotherapists, and assistant practitioners.

Each session involves one hour of aerobic and resistance exercises, tailored to the abilities of those attending. After exercising, the session concludes with education designed to help manage symptoms associated with lung disease.

 

The Home Oxygen Service provides care for patients who require medically prescribed oxygen at home to support low blood oxygen levels or to manage cluster headaches.

Referrals to the service can be completed by the following:

• After an acute hospital admission and the patient still requires oxygen therapy
• By a Health Care Professional who has identified low peripheral oxygen saturations and/or evidence of a drop in saturations on exertion.

All referrals to be sent to the Integrated Respiratory Team.

What to expect? 

Once a referral has been screened and deemed suitable, an appointment will be arranged for an initial assessment.

The need for oxygen therapy will be assessed using an arterial blood test, taken from the wrist. This test measures oxygen and carbon dioxide levels in the blood, along with other factors required to ensure oxygen therapy is prescribed safely.

Ambulatory oxygen therapy is assessed using either a six-minute walk test or a one-minute sit-to-stand test, depending on your diagnosis. During this assessment, your oxygen levels will be monitored every minute using a finger probe to check for any drop in oxygen levels.

Oxygen therapy is available in several forms:

• Ambulatory options include oxygen cylinders and liquid oxygen.
• Static oxygen concentrators use your home electricity supply to deliver a continuous supply of oxygen.
• Portable pulse oxygen concentrators require a specialist assessment to ensure the device can be triggered effectively and meets the patient’s needs. These devices are not suitable for all patients.

If oxygen therapy is required, ongoing reviews will be arranged, and the date of the next assessment will be advised by the Respiratory Team.

Oxygen needs may change over time, which can result in an increase, reduction, or discontinuation of oxygen therapy, as clinically indicated.

Medical oxygen is a prescribed medication and must not be adjusted without advice from the Respiratory Nurse, as changes may be harmful to your health.

To ensure oxygen is used safely, home safety checks will be carried out, along with any necessary referrals to the fire service.

Any concerns regarding oxygen safety and/or misuse of prescribed therapy will be taken very seriously due to the associated risks.

The Respiratory Virtual Ward (RVW) is led by a multidisciplinary team dedicated to supporting patients with acute respiratory conditions. Our service provides enhanced care for patients who require step-up or step-down interventions, with a focus on admission avoidance and early supported discharge.

Our team consists of: 

• Respiratory Clinical Nurse Specialists 
• Senior Respiratory Specialist Physiotherapists
• Respiratory Nurses and Physiotherapists

Referrals: 

We accept referrals from secondary care, based on the recommendation of a hospital Consultant or Respiratory Nurse Specialist. Additional referral sources may include:

• Urgent Community Response Team 
• General Practitioners 
• Paramedics 
• Community Respiratory Nurses 

What we offer: 

The Respiratory Virtual Ward enables us to provide timely and targeted support during exacerbations of chronic respiratory conditions.

Our team can:

• Offer a 7-day service
• Reviews within 24 hours of referrals
• Collect blood and sputum samples
• Prescribe and monitor acute medications
• Facilitate weaning of nebulisers
• Breathlessness management support
• Monitor clinical status for signs of improvement or deterioration
• Wean oxygen therapy where appropriate
• Assess for palliative oxygen within a faster time frame than standard review
• Facilitate early, supported discharge from acute care settings

Admission Criteria:

Patients eligible for Respiratory Virtual Ward must meet the following criteria:

• Aged 18 or older
• Experiencing an exacerbation of a pre-existing, non-asthmatic respiratory condition
• Recently admitted, treated, or assessed in a hospital ward, emergency department, or same-day emergency care unit, and identified as suitable for early discharge with ongoing monitoring

Clinical judgement may be applied for patients outside these parameters, where significant risk factors for poor outcomes exist. Patient and/or family must provide informed consent.

Exclusion Criteria: 

The Respiratory Virtual Ward is not suitable for patients who: 

• Are under 18 years of age
• Are experiencing an exacerbation of asthma as their primary condition
• Have advanced dementia or significant frailty
• Require oxygen levels above their baseline to maintain target saturations (clinical discretion may apply following discussion between referring and admitting clinicians)
• Have a care plan indicating no need for hospital escalation
• Reside outside the service area
• Have significantly reduced cognitive function

NELFT Respiratory Virtual Ward opening hours:

Monday — Sunday: 9am-5pm

The Breathlessness and Diagnostics Team provides diagnostic spirometry testing, including reversibility testing where indicated, as well as FeNO testing to support the diagnosis of obstructive or restrictive lung disease.

You may be referred for spirometry testing if you are experiencing symptoms such as:

• shortness of breath 
• Wheezing 
• Persistent cough 

We accept referrals from healthcare professionals for individuals aged 18 and over who do not have a confirmed respiratory diagnosis. Contraindications to spirometry testing include, but are not limited to:

• Abdominal aortic aneurysm or any other aneurysm.
• Recent stroke
• Recent myocardial infarction
• Recent eye, head, abdomen or chest surgery.
• Pulmonary embolism
• Haemoptysis- Ongoing, unresolved or of unknown origin.
• Active TB
• Recent chest infection.
• A salbutamol inhaler should be prescribed for reversibility testing.

What to expect from testing: 

Testing can take in various locations across Brentwood, Basildon, Billericay and Thurrock. Contact will be made regarding the time/date of your appointment.

On the day of testing you will be advised to:

• Avoid smoking on the day of testing.
• Refrain from consuming alcohol up to 4 hours before the test.
• Avoid vigorous exercise for 30 minutes prior to testing.
• Avoid wearing tight clothing.
• Avoid eating a large meal/caffeine for 2 hours prior to testing.
• Avoid using inhalers for a specific time frame.

The test will be carried out by a healthcare professional, who will first complete some background checks and observations, such as blood pressure, as well as measuring your height and weight.

During the spirometry test, you will be asked to breathe into a tube connected to a spirometer. This involves completing up to eight relaxed breaths and up to eight forced breaths, which allows the clinician to assess your lung function.

In some cases, you may be asked to use an inhaler and repeat the test after a short break. The full appointment should take no longer than one hour.

Some people may feel slightly dizzy or faint shortly after the test; however, this usually passes quickly.

Once the test has been completed, a report detailing your results will be prepared within 4–6 weeks and sent to your general practitioner.

For more information and support take a look at the resources below: 

Spirometry leaflet

Active cycle of breathing technique

St Luke's Hospice - Breath Wh-easy group

St Luke's Hospice drop-in exercise group

St Luke's Hospice Fatigue Management Workshop

Eating well for your lungs leaflet

Energy Conversation Leaflet

Fan Therapy

IMPROVING YOUR NUTRITION IN COPD

Instructions for patients using home nebulisers

NUTRITION SUPPORT IN COPD

Coping strategies: Positions of ease when breathless

Stay well in summer