Acute Exacerbation COPD pathway (AECOPD)

Islington
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Provided by Whittington Health Community Respiratory (CORE) team, the acute exacerbation COPD (AECOPD) service can provide urgent support for patients experiencing an acute exacerbation of COPD in their own homes. The service aims to visit patients within 24-48 hours of referral, Monday-Thursday, or within 72 hours for referrals received on Fridays. Referrals can be received up to 4.30pm on a working day.

The service provides up to six home visits with the aim of ensuring: 

  • safe admission avoidance
  • upskilling patient self-management
  • support for stop smoking interventions
  • encouragment to complete pulmonary rehabilitation.

Patients will be discussed in virtual MDT with the integrated respiratory consultant.

A face-to-face assessment by the GP is a prerequisite for referring to the service, unless the patient has previously been case-managed and is already known to the community respiratory team.


Eligibility criteria

Inclusions

  • confirmed diagnosis of COPD
    • post bronchodilator airflow obstruction on spirometry: FEV1/ FVC < 0.7 
    • symptoms of cough, sputum, breathlessness and a history of smoking in a patient age 35+.
  • symptoms typical of an acute exacerbation
    • increase in breathlessness/ sputum purulence from usual baseline over a 24-hour period
  • when other causes of increased breathlessness considered by the referring clinician and thought unlikely (such as pulmonary oedema, consolidation, pulmonary embolism, pneumothorax).
  • self-referral is possible, if already on the caseload of the Islington Community Intermediate Chronic Obstructive Pulmonary Disease (COPD) Service

Exclusions

  • patients with concurrent asthma should not be managed on this pathway, but should be clinically assessed by their GP as to whether they need acute admission to hospital as per asthma guidance
  • patients with new respiratory failure (oxygen saturations </= 92%) are not suitable for this pathway and should be admitted to hospital for safe assessment

How to refer

The following clinicians can refer to this service: GPs

Letter

Referral methods: Email

A referral form can be found in ISL EMIS under
ISL global documents > LTC  > Long term conditions community service referral (select AECOPD)

e: articentralbookings@nhs.net

The community respiratory team can be contacted via telephone to discuss the suitability of the referral.
t: 07919 575 653

The integrated respiratory consultant can also be contacted to provide telephone advice.
t: 07768 728 992

If patients are referred on this pathway direct from ambulatory care or the emergency department at Whittington Health or UCLH their GP will be informed.