Domiciliary non-invasive ventilation
Clinical lead and clinical team
The home non-invasive ventilation (NIV) service at Harefield Hospital is run by a dedicated team which includes: Dr Amanda Natanek (respiratory consultant); Dr Shirmila Withana (consultant-grade associate specialist); the respiratory specialist registrar; Sharyl James (clinical nurse practitioner); respiratory physiologists Ian Dear, Peter Dickel, Amna Hoda and Suraj Ubhi; Melanie Curtis (physiotherapist); administrator Kerry Richardson; and the nurses on Cherry Tree ward.
What happens on the day of the clinic?
Patients are admitted from home or transferred from their local hospital for the day to assess the need for home ventilation. When appropriate, a ventilator and the required training are provided prior to discharge. Regular follow-up appointments occur on Cherry Tree ward and overnight sleep monitoring is sometimes performed to ensure the ventilator settings are optimal.
Home oxygen service
Clinic summary
The home oxygen service, based in Harefield Hospital, provides comprehensive assessment and reviews for patients with long-term respiratory or cardiac disease referred for consideration or management of home oxygen. This includes both long-term oxygen therapy and ambulatory oxygen therapy.
The service provides multiple clinics that run each week.
Clinical lead and clinical team
Dr William Man – consultant respiratory physician
Dr Samantha Kon – consultant respiratory physician
Ola Omitoyin – oxygen service coordinator
Melanie Palmer – highly specialist physiotherapist
Liz Fletcher - highly specialist physiotherapist
Provision of acute oxygen therapy
All members of the clinical team can provide acute home oxygen, via the webpage if the patient lives in Hillingdon or London or using the home oxygen order form A if they live in Hertfordshire/Buckinghamshire or Berkshire.
This allows prescription of a static concentrator or a large static cylinder. You will not be able to order ambulatory oxygen.
This form is suitable to supply temporary oxygen prior to a formal assessment by an oxygen service before hospital discharge or for the provision of palliative oxygen.
It is the responsibility of the prescribing clinician to complete a risk assessment form and to ask the patient to sign a consent form (IHORM).
The prescriber should also explain that the patient will be formally assessed for oxygen therapy once their condition has stabilised and that oxygen therapy may be withdrawn in the future.
Long-term oxygen therapy assessment
The patient will be offered an assessment by the oxygen co-ordinator. Assessments are completed on the day-case ward at Harefield Hospital by a member of the home oxygen assessment team.
Ambulatory oxygen therapy assessment
The patient will be offered an assessment by the oxygen co-ordinator and will be seen in the physiotherapy department at Harefield Hospital. The assessment involves a number of walking tests.
All patients known to the oxygen service will be periodically assessed, to review their use of and need for oxygen therapy.
Referrals
Patients can be referred either externally or internally via the referral form, which should be faxed to 01895 828851.
Physiotherapy respiratory outpatient service
Clinic summary
The physiotherapy respiratory outpatient service at Harefield Hospital provides assessment and treatment of patients with acute or chronic respiratory disease, with a focus on empowering patients towards effective long-term self-management.
Respiratory physiotherapy normalises and maximises breathing function through breathing control exercises and re-education, sputum clearance techniques, postural exercises, relaxation therapy and patient education. It may also include the use of positive expiratory pressure (PEP) or acapella devices.
Patients can also be assessed for and provided with a compressor/nebuliser.
Patients are assessed on an individual basis, and the number of treatment sessions will vary depending on the specific needs of each patient.
Clinic days
Tuesdays, Wednesdays and Thursdays.
Who should be referred?
Patients with airway clearance problems, which may include conditions such as:
- chronic obstructive pulmonary disease (COPD)
- bronchiectasis
- chronic chest infections
Patients with dysfunctional breathing patterns, including:
- hyperventilation syndrome
- asthma
- problems with breathlessness
- panic attacks
How can patients be referred?
We accept referrals from:
- consultants
- GPs
- other healthcare professionals including respiratory physiotherapists, and nurse specialists.
Please complete the referral form (XLS, 510KB) and send to:
Physiotherapy outpatients department
Harefield Hospital
Hill End Road
Harefield
Middlesex
UB9 6JH
Respiratory rapid response (HR3)
Clinic summary
Harefield Hospital respiratory rapid response clinic is a consultant-led multidisciplinary one-stop service that aims to rapidly treat the exacerbation of chronic respiratory disease to prevent clinical deterioration and need for acute hospitalisation. Patients will be seen by a senior respiratory doctor and appropriate cardiopulmonary investigations performed. If necessary, changes in medication, appropriate prescription of oxygen, initiation of nebulisers, and chest physiotherapy can be provided in a one-stop clinic.
Clinic days
Tuesdays and Fridays
Clinical lead and clinical team
Dr Shirmila Withana
Sharyl James
Melanie Curtis
Who should be referred?
Patients must be current or past patients known to Harefield Hospital's respiratory medicine or pulmonary rehabilitation teams with a clinical deterioration in their chronic respiratory disease. Patients requiring urgent acute hospital management should not be referred to this clinic.
Referral process
Phone call to the clinical team to be supplemented by a faxed summary.
Please contact the specialist physiotherapist (Melanie Curtis on bleep 6434) or the respiratory registrar via switchboard to discuss the case.
Letter / fax to 01895 828851