Integrated Community Respiratory Services

What we do

We offer a range of support services to enable patients with chronic respiratory conditions to be cared for at home where possible, rather than be admitted to hospital.

When hospitalisation is needed, we work to make this is as short as possible, and provide appropriate discharge support.

How we work

We work alongside primary health care teams, including occupational therapists, physiotherapists, social and care workers, and GPs who refer their patients to the service.

Once patients have been assessed, they can contact the team directly when they need support or become unwell.

What we offer

We offer patients education about as how diet and exercise can help with their illness, and support their families too: acute episodes of respiratory illness can often be frightening for relatives, and our team can respond quickly respond quickly to help families and carers deal with any episodes.

The service runs from Monday to Friday from 8.00am to 4.30pm.

You can access this service via our referral from a GP or another healthcare professional.

Who we see

  • Patients with a diagnosis of chronic obstructive pulmonary disease (COPD) or asthma.
  • Patients with interstitial lung disease who have symptoms of the disease, and may need palliative care.
  • Any adult patient with chronic respiratory disease who has functional limitations due to breathlessness.
  • Any patient who is hypoxic and may benefit from long-term oxygen.

Our service


  • Manage exacerbations of chronic obstructive respiratory diseases (COPD) and asthma through in-reach to acute hospitals and through community care.
  • Manage patients with unstable respiratory conditions who need might need help managing their illness better, as well as support and education so that they can manage their condition themselves.
  • Manage patients who are functionally disabled by breathlessness who would benefit from a course of pulmonary rehabilitation – all referrals are offered assessment followed by 12 sessions of rehabilitation over 6 weeks.
  • Manage hypoxic patients who need home oxygen. We assess new patients over a minimum of 2 appointments, and we follow up all patients at least once a year, until oxygen is no longer needed.
  • Provide education to patients, carers and other health care professionals regarding respiratory and oxygen needs.

Our expertise

Our skills and expertise include:

  • Specialist respiratory assessment and management of patients with chronic respiratory diseases.
  • Delivery of patient education programmes.
  • Knowledge of disease management in line with national guidelines.
  • Palliative care support, particularly of severe breathlessness and psychological symptoms related to chronic respiratory disease.
  • Monitoring of oxygen use and analysis of results.
  • Ordering appropriate oxygen therapy and equipment.
  • Assessing disability related to respiratory function.
  • Advising on exercise prescription.
  • Well-developed teaching and facilitation skills to deliver training.

Accessing our services

Patients who have already been seen by our team can request a referral, but otherwise, you’ll need to be referred by a GP or another healthcare professional, such as district nurses or staff on an acute ward.


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Page last reviewed: 21 November, 2023