“THINK COPD, THINK CRT”
The Team
The Edinburgh Community Respiratory Team (CRT) is an interface service led by Advanced Physiotherapy Practitioners. The team has dedicated and co-located pharmacy and psychology input.
CRT has 3 main work streams:
- Prevention of admission and acute exacerbation support for patients in their own home with the aim of avoiding unnecessary admission to hospital
- Supported discharge from hospital
- Chronic disease management.
This is an Edinburgh City service and operates in the health and social care partnership boundaries. Midlothian, East Lothian and West Lothian have a similar service with their own RefHelp pages.
Services
Provided
The team works Monday to Friday 8-6 and Saturday and Sunday 9-4. The service runs 365 days a year to support the management of COPD patients residing in the City of Edinburgh.
The service offers
- Advanced Physiotherapy Practitioners with independent prescribing qualifications able to prescribe where appropriate, order Chest X-Rays and Pulmonary Function Tests and who have direct admission rights to WGH and RIE Edinburgh. We offer rapid assessment, aiming to see urgent referrals the same day they are referred or the following day as required by their clinical condition.
- Direct contact with respiratory consultants for urgent specialist advice on the management of complex patients
- Access into a dedicated Clinical Psychologist service for COPD patients, see COPD Psychology Service for more details
- Specialist input from an Integrated care pharmacist
- Provision of anticipatory care e.g. prevention advice, education and support to carers
- Partnership working with acute Respiratory Nurse Specialists, Edinburgh IMPACT Team and the pan-Lothian pulmonary rehabilitation service
- Referral to smoking cessation services
- Access to voluntary sector organisation Grapevine for home visits to support patients to access benefit support Grapevine Community Respiratory Support Service
- Patients will be assessed and considered for longer term management via our Lite Touch self referral service
- Provision of education/support/advice to healthcare professionals regarding the management of patients with COPD in the community.
C.W. & L.G. 04-05-23
Who to refer:
Urgent Referral Criteria
Patients with a:
- Primary diagnosis of COPD (on previous spirometry)
AND
- An acute exacerbation of COPD.
AND
- Who are residents of the City of Edinburgh (within the health and social care partnership boundary).
Routine Referral Criteria
- Patients with frequent exacerbations not currently at risk of admission
- Patients with general deterioration in function due to their COPD
- Supported discharge patients.
Who not to refer:
- Primary diagnosis of Asthma, Bronchiectasis, Lung Cancer, Interstitial Lung Disease, Cystic Fibrosis, Suspected TB
- Diagnostic uncertainty
- Patients who GP feels cannot be managed safely at home – (see home vs hospital)
- Patients with reduced consciousness or confusion
- Patients who are not residents of the City of Edinburgh.
How to refer:
Urgent Referrals
All urgent referrals MUST be called through the on-call mobile number 07826894067. Please note this is a professional line only. This is not to be given to patients.
An electronic SCI gateway referral must then be completed.
Urgent referrals from Primary Care will be triaged and visited the same day if required.
Routine Referrals
Routine referrals do not need to be discussed with the on-call team. A referral should be sent via Sci-gateway. These patients will be triaged and offered an appointment as capacity allows. Please note at busy times we run a waiting list for non-urgent reviews.
Both urgent and routine referrals require completion of an electronic referral via SCI Gateway. Select AHP – Physiotherapy > Edinburgh – Astley Ainsley Hospital > LI Community Respiratory Team
The SCI Gateway referral form requests the patients Clinical Frailty Score. Please see Clinical Frailty Score.pdf for information on this scoring system.
COPD: Chronic Obstructive Pulmonary Disease
Respiratory: Respiratory
Spirometry: Spirometry –
RIE Hot Clinic: RIE Respiratory HOT Clinic
SDEC: Same Day Emergency Care (SDEC)
Oxygen Therapy: Oxygen Therapy
CRT Poster: Respiratory-Community-Respiratory-Team-Poster-frm-Intranet-Sep18.pdf (nhslothian.scot)
GOLD: 2023 GOLD Report – Global Initiative for Chronic Obstructive Lung Disease – GOLD (goldcopd.org)
Respiratory MCN: NHS Lothian Respiratory Managed Clinical Network (MCN) – Respiratory
Asthma and Lung UK: Who we are | Asthma + Lung UK (asthmaandlung.org.uk)
CHSS: About Us – Chest Heart & Stroke Scotland (chss.org.uk)
Smoking cessation: NHS stop smoking services help you quit – NHS (www.nhs.uk)
Dolby Medial (home oxygen supplies): 0800833531
Vocal: Support for carers in Edinburgh and Midlothian – VOCAL
Active Scotland: (cannot find an active link for this?
My Lungs My life: My Lungs My Life | Patient Respiratory Self-Management Toolkit
SAS Pathway: Resp-CRT-Scottish-Ambulance-Service-Pathway-Checklist.pdf (nhslothian.scot)
Psychology: www.wellbeinglothian.scot
