Our Services

Integrated Respiratory Team

We are a team of specialist nurses and physiotherapists that specialise in treating patients with chronic (long-term) lung conditions. We see patients in hospital, in community and hospital clinics and in their own homes. We aim to provide specialist care to patients living in the East Cheshire, South and Vale Royal locality.

Our services

  • Supported Early Discharge: This is a service for patients admitted to hospital with an exacerbation of their Chronic Obstructive Pulmonary Disease (COPD). The aim is to help get the patient discharged from hospital (to the support of the team) as soon as it is safe to do so. Once discharged this is normally in the form of a daily home visit for the first few days followed by telephone reviews as appropriate. 
  • Oxygen Assessment Clinics: This aspect of the service is offered to patients who may need oxygen therapy as part of their treatment plan. A full assessment is undertaken, which includes a blood test (a small amount of blood is taken from the ear) and a walk test. None of these tests should be painful but they are necessary to find out who needs oxygen and how much. It is important that everybody who has oxygen at home attends these clinics. The first appointment will be in the hospital setting and all review appointments in either the community oxygen clinic or in the patient’s home if required.
  • Nebuliser trials: Nebulisers are devices that are designed to deliver stronger dosages of medication to the lungs in a fine mist. A nebuliser is often used for a short period of time when the patient is having a flare up of their condition but in some patients with severe breathing difficulties nebulisers may be helpful long term however, the patient needs to be assessed for this. The Integrated Respiratory Team (IRT) will organise this for the patient once a referral from the health care professional has been received.  
  • Pulmonary rehabilitation: This is a specialised exercise and information class for people with lung conditions. The pulmonary rehabilitation programme helps to keep the patients as fit as possible, helps the patient and their carers to understand the condition and the best way to control those symptoms. The programme teaches the patient how to deal with flare ups (exacerbations) and most importantly how to get on and enjoy life as much as possible. The patient attends the class for 2 hours twice per week for a period of 6 weeks. They will be invited for an initial assessment by the physiotherapists prior to commencing the class.
  • Home Support: This service is for patients who are experiencing an exacerbation of COPD. The aim of this service is to prevent hospital admission by supporting the patient at home. Housebound patients may benefit from this service and those with severe disease who may be nearing end of life and have chosen to remain at home with their family.
  • Palliative Care support: The IRT can give advice and support to help patients and their carers control the symptoms of breathlessness, pain and other distressing symptoms such as panic, anxiety and depression that can be associated with severe and late-stage lung disease. The IRT links in with the palliative care teams at the East Cheshire Hospice in Macclesfield and St, Lukes Hospice in Winsford.  
  • Out-patient and Community Specialist Clinic: The patients may require a full assessment of their lung condition especially in cases where the condition may not be responding to treatment as well as expected or where further investigation or medication optimisation is required. The clinics are held in Macclesfield and Leighton Hospitals, Handforth Clinic, Knutsford Community Hopsital, Waters Green Medical Centre in Macclesfield,Dene Drive, Winsford, Eaglebridge Health and Wellbeing Centre,Crewe and Weaverham Clinic in Northwich.
  • Advice and resource: Advice can be given over the telephone for clinicians, patients and carers.  

How do I refer/access the service?

The team operates a ‘single point of referral’ system. This means if you are referred you can have access to any of the services offered without having to have a new referral.

We will accept referrals from your hospital consultant, GP, physiotherapist or nurse.

Those patients, who attend the oxygen assessment clinic or have been seen at home by one of the respiratory team before, can contact the team directly for advice when symptoms worsen.

How to contact us

The Integrated Respiratory Service operates from Macclesfield and Nantwich from 8.00am – 6.00pm seven days per week.

Lead Nurse:   Alison Graham- 01625663380 or a.graham2@nhs.net

1. The Macclesfield Team is based at:

1st Floor, New Alderley House

Macclesfield District General Hospital,

Victoria Road,

Macclesfield,

SK10 3BL

Telephone: 01625 663380

Fax: 01625 661813

2. The Crewe Team is based at:

Church View Primary Care Centre

Beam Street,

Nantwich,

Cheshire,

CW5 5NX

Telephone: 01270 275437

Fax: 01270 629236  


Useful information

It is important for patients with lung disease to look after themselves and their general health. There are many things that they can do to keep well.

  • Stop smoking: Stopping smoking helps to slow down the rate of lung function decline and is a proven effective intervention. It is considered a part of the patient’s treatment plan and should be offered to all who smoke. Support and advice is available as listed in the useful resources section.
  • Exercise: Keeping active is extremely beneficial in many ways. Although breathlessness on effort can be uncomfortable, it is not necessarily serious. If there is any doubt about exercise then it is important to discuss the concerns with a health care professional. Walking at a steady pace with frequent stops if you become breathless (stop until breathing gets back under control) is a good way to gently exercise. The aim is to have 20-30 minutes per day. Trying to increase the amount walked every day leads to improvements in symptoms.
  • Breathing exercises: Breathing can be much more efficient if more use is made of the diaphragm (muscle that lies between the lungs and abdomen). It is best to ask for some advice about the correct breathing exercises to do from a physiotherapist or the respiratory team.
  • Eat well: Keeping weight correct and maintained for height is essential as we use more energy and oxygen to carry the extra weight and this increases breathlessness and decreases activity. People with lung disease need more energy to breathe so getting too thin means they get more tired, are more prone to infection and they lose their muscle strength and tone. It is very important to seek advice if losing weight as a dietician referral may be required. 
  • Self Management: It is important that the person with COPD and other lung conditions knows how to recognise when they are developing infection and/or a worsening of symptoms. Most patients’ with COPD should have a rescue pack of antibiotics and steroids at home to take when symptoms develop and contact numbers for advice and support.
  • Influenza and Pneumococcal vaccinations: These vaccinations have been proven to benefit patients with lung disease. The GP practice normally invites the patient to attend for flu vaccination annually and in most cases the pneumococcal vaccination is required only once.
  • Going on holiday and flying: Some patients may require oxygen in flight if travelling by aeroplane so in these cases a fitness to fly test is required. Contact the IRT for further information. 
  • Understand the medications: It is important that patients understand and have been shown how to use their inhalers properly. Medication use and the reasons for use should always be explained by the health care professional.
  • Government allowances: Patients with lung disease may be entitled to governmental financial support. Contact the Benefits Agency Enquiry Line on 0800 882200 or the Department for Works and Pensions website  www.dwp.gov.uk for more information. 

 

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