Leicestershire Partnership NHS Trust - Lung patients benefit from daily monitoring

Caring for patients at home during the pandemic

NHS care isn’t just about big city hospitals and GP surgeries. There are a range of community health services, many of these are delivered by Leicestershire Partnership NHS Trust (LPT).

To respond to the pandemic, we at LPT have changed the way we deliver some services. But we have worked successfully to give patients the care they need, while ensuring that we have maximised protection to patients and staff from possible sources of infection. Over the past few years, health and social care services have given a greater emphasis on helping people avoid going into hospital at all, or to getting home sooner if they do have to go into hospital. This meant we were in a good position to care for the very many older or vulnerable patients who were advised to shield in the earlier stages of the pandemic. We have a Home First pathway which enables us to give patients who are most unwell, or who require a rapid response to help them with a health or care crisis, a more intensive period of care. We work alongside social care colleagues to provide a crisis response to prevent an admission to hospital, or reablement for patients coming out of hospital – getting them back to their optimum level of health as quickly as possible. These services are delivered by professionals including nurses, physiotherapists, occupational therapists, and healthcare support workers. Throughout the Covid period community nursing and therapy services have continued, though they have focussed on the patients most in need of care at home, and provided fewer clinic-based appointments. Our community nursing teams provide a wide range of nursing care to patients in their own homes. One important part of their role is supporting patients to self care. That includes teaching patients how to give their own eye drops, or how to inject themselves with insulin, or sometimes, training another member of the family to do this for a patient, while making sure that there is somebody there to support them if they have any problems. Self care is really important and can help our patients regain an extra dimension of independence while remaining safe. We have developed a number of new services specifically to address the needs of the pandemic. For a number of our heart and lung patients, we developed a service

(from the left) Sam, Nima, Tia and Suzy

which uses new technology so we can monitor their condition day-by-day, while they remain at home away from possible sources of infection. They take their own blood pressure, pulse and blood-oxygen and complete a simple questionnaire about how they are feeling and what physical activities they are doing. Our clinical staff look at this data remotely, and can voice or video call them where needed to offer support and advice. We also set up similar remote monitoring for Covid patients who were in hospital and on oxygen. This has meant they could return home to their families more quickly to complete their recoveries while under close clinical supervision. Our therapists (physiotherapists, occupational therapists, speech and language therapists) have not been doing all the visits that they might have done previously in the same way. Instead, they have focussed on patients who have needed more urgent and intensive support. One of the things that they have developed through this time is a much greater use of telephone calls and video conferencing to assess the condition of individual patients, and to give them advice and information about how best to manage or improve their condition. This has been appreciated by patients. One physiotherapy patient said: “They contacted me to offer support on the phone during the Covid 19 crisis. They didn’t forget about me.” Another added: “My care has been exemplary.” Another important part of our role is supporting patients at the end of their lives. Most patients want to die surrounded by their family and friends – something that has been severely curtailed in hospitals due to Covid restrictions. We have also continued to visit patients in their own home to deliver face-to-face care where this is needed. In these cases our staff wear enhanced personal protective equipment including masks to minimise the risk of passing on the Covid-19 virus. They also continue to wash their hands and wear fresh aprons and gloves for new patients, as they were doing before the pandemic. To hear more from the team, follow this link: https://youtu.be/dPxmTdfewOs .