Information
The East Lothian Community Respiratory Pathway is hosted within the East Lothian Rehabilitation Service (ELRS) and is delivered by a team of Advanced Physiotherapy Practitioners (APP’s) based in the community. The team has close links with the Respiratory Consultants in the RIE and the Respiratory Nurse Specialists, attending fortnightly MDT’s for time sensitive, specialist advice.
The team’s role is to support the management of patients with long-term respiratory conditions including (but not limited to) COPD, Bronchiectasis and Asthma. This support can be during periods of acute exacerbations, for prevention of admissions, supported discharge from hospital or for identified longer term self-management needs. Many of the team are qualified, independent non-medical prescribers who can prescribe during acute exacerbations and refer for Pulmonary Function Tests (PFTs). The Community APPs are also able to see patients with acute or ongoing post/long-covid symptoms.
The Community APP Team core hours are Monday – Friday 8am-4pm
Currently there is no provision for accepting referrals out of hours
Interventions provided include:
- Self-management advice and education
- Nebuliser trials
- Inhaler reviews & recommendation for changes to GPs
- Airway clearance
- Breathlessness management
- Provision of acute prescriptions e.g. to prevent hospital admission
- Liaising with GPs regarding antibiotic treatment & COPD management
- Post hospital discharge oxygen weans
- Pulmonary Function Test referrals
- Dysfunctional breathing retraining
- Involvement in anticipatory care planning conversations
- Provision of Home Pulmonary Rehabilitation/ Home Exercise Programmes
- Provision of equipment, walking aids, review of transfers and mobility
Who can refer:
Primary Care:
GP’s, Practice Nurses and ANPs via SCI Gateway
Secondary Care:
Consultants, Respiratory Nurse Specialists, Acute physiotherapists in the RIE and WGH for supported discharge
AHPs:
Community AHPs within the wider East Lothian Rehabilitation Service
Patients:
Self-referral for PT/OT input is available to all East Lothian residents – see below for details of the ELRS Single Point of Contact Phoneline
Who to refer:
Residents of East Lothian with:
- Frequent exacerbators
- Long-term Respiratory conditions with poor self-management in community
- Acutely unwell patients for Prevention of Admission visits
- New Respiratory diagnosis
- Post Covid/Long Covid
- Respiratory supported discharges
- New LTOT
Who not to refer:
- Routine breathlessness management/chest clearance (refer to Community Physiotherapy)
- LRTI without underlying long term respiratory condition
- Undiagnosed respiratory condition
How to refer:
Primary Care Pathway:
Referrals should be made via SCI Gateway
AHP – Physiotherapy > East Lothian – East Lothian- East Lothian Rehabilitation Service > LI Physiotherapy and specify ‘Respiratory Pathway’ in the drop-down box.
Secondary Care:
Acute referrer to call 01620 642834 to make direct professional to professional referral over the phone.
Patient Self-Referral:
Patient/family member/carer can call ELRS Single Point of Contact Phoneline on 0300 3690680 to self-refer for Physiotherapy input, including for the management of long-term respiratory conditions.
2022 GOLD Reports – Global Initiative for Chronic Obstructive Lung Disease – GOLD (goldcopd.org)
Respiratory -Lothian COPD Guidance April 2018 v0 4 Combined (2).pdf (nhslothian.scot)
Home – Access to a Better Life in East Lothian – ELRS Digital Platform with advice, resources and external links to support self-management
