The oxygen and respiratory case management team provides respiratory care for people with chronic pulmonary obstructive disease (COPD). We work with you, sharing decision making with you and helping you take care of yourself. We take a proactive approach to identifying and supporting high risk patients.

Our aim is to keep people well and living independently in their own homes wherever possible, from diagnosis to end of life.

The service includes:

  • Home oxygen service – assessment and review (HOSAR)
  • Management and specialist support of patients with unstable or more complex respiratory disease
  • Primary care education and support.

Home oxygen therapy helps people who don’t have enough oxygen in their blood. It involves breathing in air that contains more oxygen than normal through a mask or tube connected to a device in your home.

Visit the NHS website for more information on home oxygen treatment

The service is for people who are:

  • Aged 18 and over
  • Registered with an Ealing GP practice
  • Living within 1 mile of the boundaries of the London borough of Ealing
  • Receiving oxygen therapy for a respiratory condition identified through the oxygen prescription service, or identified as having a long term respiratory condition requiring enhanced case management.

As well as reviewing and managing their respiratory condition, we support patients to look after themselves. This is called self-care. We also help other medical teams learn about respiratory care.

Self-care

This includes:

  • Education about stable respiratory disease and flare-ups
  • Education and support for oxygen use
  • Advice and guidance about airway and secretion clearance
  • Managing breathlessness
  • Advice and continuing programmes to support self-management. 

Review and planning

These include:

  • Medication review, including inhaler devices and inhaler technique
  • Assessment for long term oxygen therapy and ambulatory oxygen therapy (including capillary blood gas sampling and oxygen prescription)
  • Screening and support for anxiety and depression
  • Advanced care planning
  • Home visits for flare-up/exacerbation management.

Joint working

  • Education and support to non-specialist clinicians
  • Joint working with a range of community services, for example, Rapid Response and palliative care.

This service will assess and support people who’ve been identified as needing home oxygen by their GP or a hospital.

They’ll have an initial home oxygen assessment and follow up visits to check how they’re coping with home oxygen and to encourage and support self-care.

They’ll also be supported to stop using home oxygen therapy, where appropriate.

This service is for patients whose respiratory disease is more unstable or complex. They’re likely to have had more than 2 flare ups or episodes of worsening conditions in a year, with or without hospital admission.

Patients will be supported with self-management strategies, including:

  • Respiratory medication review
  • Flare up/exacerbation education
  • Psychology support for anxiety and depression
  • Activity advice
  • Smoking cessation advice. 

They’ll get a personalised self-management plan and information about where to get help if they have a flare up/exacerbation, and when to use a Home Rescue Pack.

We aim to see you in the most appropriate setting for you:

  • Your home
  • Clinics across Ealing.

Referrals can be made by:

  • GPs
  • Rapid Response and other community services
  • Other healthcare professionals
  • Secondary care
  • Community matrons.

The normal route of referral is through the Ealing referral hub.

Email: ealingcommunity.referrals@nhs.net

Telephone: 0300 123 4544

We want the oxygen and respiratory case management team to be a resource for healthcare professionals. We can provide support when you need it, with more formal support and training, to ensure that respiratory care is provided to a high standard across Ealing.

We support: 

  • Undergraduate physiotherapy and nursing placements with key providers of undergraduate education within the area
  • Other clinicians doing postgraduate courses or qualifications, for example district nursing or non-medical prescribing. 

In turn, we’re supported by consultant training, education through multidisciplinary team and clinical governance meetings, post-graduate training and clinical and networking events.