Case Study

Knowsley community respiratory support service

How a respiratory rapid response car became a fundamental resource during the COVID-19 pandemic, supporting patients displaying COVID-19 symptoms.

11 February 2021

The Knowsley Community Respiratory Service is commissioned to support hospital admission avoidance, working closely with local district general hospitals, clinical commissioning groups (CCGs) and North West Ambulance Service (NWAS). An existing pilot respiratory rapid response car became a fundamental resource during the COVID-19 pandemic, supporting patients displaying COVID-19 symptoms.

What the organisation did

In December 2018, a respiratory rapid response car was piloted by the Knowsley Community Respiratory Service, staffed with senior clinicians from the community service alongside an experienced paramedic.

The pilot was a great success, and this success played a fundamental role in ensuring the funding was extended when the pandemic hit, specifically for those patients displaying symptoms of COVID-19 who required a hospital admission. Staff did all they could to care for this patient group and advise families of isolation protocols.

The Knowsley Respiratory Service also has two nurses working directly in A&E to support early supported discharge for any patients admitted, regardless of the CCG. This has been hugely beneficial when working closely with the NWAS car and community rapid response teams.

Both the respiratory and the NWAS teams quickly developed collaborative ways of working for the success of the pilot. The funding was initially provided until the end of March 2020, but an extension was agreed to until the end of June 2020.

Results and benefits

The staff adapted to a new way of working and went above and beyond for patients, often spending hours at a time transferring patients to hospital on the back of ambulances while trying to stabilise symptoms in a safe and caring manner. Patients who did not have the benefit of the respiratory car with the experienced clinicians working alongside paramedics, would have probably been admitted to hospital during the peak COVID-19 time, putting this highly vulnerable group at risk of infection.

The car finished its service on 28 June 2020 after six months, during which time the service helped to avoid 261 admissions, 149 of which were within four hours.

The data collected by the scheme will support the surrounding respiratory teams to develop a generic service so that all patients can receive the same care and reduce health inequalities. 

During May and June, the number of referrals dropped significantly and a decision was made to pause the pilot, evaluate the full impact, and identify funding for the coming winter.  The team was integrated into the trust’s respiratory department and offered an excellent bundle of respiratory care to each and every patient, regardless of their postcode.

What is needed to sustain the innovation

The trust is hoping to start the respiratory car initiative this coming winter, however funding would be required for this. The trust is hopeful that funding will be provided in light of the full evaluation, winter pressures plans and potential second wave of the pandemic.