Domiciliary Home Visiting Service

The domiciliary home visiting service provides access to services for adults with a confirmed respiratory diagnosis.

We aim to deliver active care delivered within the patient’s home environment by a specialist multidisciplinary team.

 

Inclusion Criteria

The domiciliary home visiting service accept referrals for patients aged 17 years and over with the following conditions:

• chronic obstructive pulmonary disease (COPD)
• bronchiectasis
• chronic asthma
• interstitial lung disease

 
Exclusion Criteria

The key objectives of the service are to:

• provide specialist care to adults of 35 years or over with unstable episodes of the above respiratory conditions, using a multidisciplinary approach;
• prevent hospital admissions and reduce the length of hospital stay using both ‘in reach’ and ‘outreach’ strategies;
• prevent hospital readmissions within 28 days of discharge;
• ensure prompt, optimal management and integrated care for all patients in line with evidence-based guidance, providing:
       - expert care in the community when appropriate
       - admission to hospital when required
       - support early, structured and assisted discharge of patients with COPD, chronic asthma or bronchiectasis when appropriate;
• to ensure effective management of comorbidities, optimisation of therapy and smoking cessation as appropriate;
• to support patients within their home to prevent hospital admission or facilitate discharge following a hospital admission;
• to minimise the impact of the disease (through faster and more effective treatment of exacerbations and fewer hospital admissions and re-admissions);
• improve symptom control, function and quality of life for all patients with the disease;
• ensure effective communication with the patient and support for self-management;
• co-ordinate with all disciplines across the care pathway to ensure integration and effective communication with GP services, secondary care providers and social services as appropriate;
• provide specialist support, when required, to patients in the end stages of their chronic respiratory condition.

 

Virtual ward home visit referral form