Community Respiratory Hubs save unnecessary trips to Leicester’s hospitals

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A new service in Leicester for children with acute respiratory illness has enabled more than two thousand children to receive urgent treatment in the community since December, without having to go to hospital.

The Leicester, Leicestershire and Rutland Integrated Care Board (LLR ICB) set up an Acute Respiratory Infection (ARI) Hub last December at the Willows Medical Centre, next to Leicester General Hospital. The Hub was established on a trial basis for the winter period, when Strep A led to increased demand, to improve the availability of care for children with ARI and reduce ambulance call-outs, A&E attendances and hospital admissions for patients who could be treated in the community.

The Hub has achieved its goals, with just 1% of patients seen at a Hub needing to be referred on to the emergency department. This means that 99% of patients received the timely treatment they required, without having to attend hospital.

Following the success of the initial Hub a further seven Hubs have now opened across the region, to ensure that there is a Hub in a convenient location wherever patients live. The new Hubs are seeing adults as well as children and they will be open until 31 March, to coincide with the end of the winter period, when respiratory infections are most common.   

Dr Imad Ahmed, Consultant in Paediatric Respiratory Medicine at University Hospitals of Leicester NHS Trust, and Children and Young People’s Clinical Lead for LLR ICB, said: “Acute respiratory infection is the most common reason for attendance at the emergency department over the winter months.  It is so much more convenient for patients to go to one of the Respiratory Hubs instead. It means that they are able to be seen in a timely manner, closer to home, and without a potentially long wait in the emergency department. I am really pleased with the excellent service that our Hubs are providing, especially during the exceptionally busy winter we have just experienced.”

National figures show that 40% of patients who go to emergency departments for respiratory symptoms are discharged after a few hours and, in most cases, it would have been more appropriate for them to be seen in the community rather than in hospital. 

The ARI Hubs provide a same-day, face-to-face assessment service for children and adults who are suffering with an acute respiratory symptoms, including cough, cold, wheezing and symptoms of infection, as long as they do not require urgent hospital care.

Patients need to be referred for an appointment, they cannot just walk in, and referrals may be made by any GP practice in LLR or by the NHS111 service.  The Hubs are open from Monday to Friday from 1pm to 8pm and also offer some Saturday appointments.

Lucy Haye recently took her son Alfie, who’s 15, to the Acute Respiratory Hub at The Willows, when he had breathing difficulties caused by tonsilitis.

Lucy said: “Alfie’s had asthma since he was little, and when he gets a cold or similar virus he always has to use his inhalers to help his breathing. Usually that does the trick, but on this occasion he was really struggling.  The GP practice had no appointments left that day, but instead they made us an appointment at the Respiratory Hub, and it was such a relief. The appointment was in the evening which was really convenient and it’s close to where we live. They checked Alfie out and prescribed penicillin.

“The Emergency Department in hospital is the last place Alfie would want to be, as it’s an environment he finds it hard to cope with. This was a quick, efficient alternative service and I was so grateful he could be seen that same day.”

Dr Louise Ryan, GP and Clinical Lead for Respiratory Illness with the LLR ICB, said: “Most respiratory infections can be cared for at home, without the need for specialist medical support, by getting plenty of rest, using painkillers, and drinking lots of water. Your community pharmacist  can also give advice on how to self-care. However, if you have a weakened immune system or a long term health condition, or if you feel especially unwell and are getting worse, you can use the NHS111 service or contact your GP practice. If you are assessed as needing urgent care, they can refer you to one of the ARI Hubs, usually on the same day.

“As well as being convenient for patients, the ARI Hubs are also reducing pressure on our GP practices and freeing up appointments for patients with more complex needs and long-term health conditions. We will be looking into making the Hubs available again next winter, as they provide benefits across the health system.”

General advice on treating respiratory infections is available on the NHS website: https://www.nhs.uk/conditions/respiratory-tract-infection/.

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