DRAS

Welcome to the Dudley Respiratory Assessment Service (DRAS).

We are a team of consultants, specialist nurses, physiotherapists and clinical support workers providing care for patients who have a suspected or confirmed diagnosis of respiratory disease, including chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis, pulmonary fibrosis and other respiratory illness. The team is supported by secretaries at both community and hospital bases.

DRAS offers both inpatient and outpatient care for the people of Dudley and surrounding areas.

7 days a week, 365 days a year.

One of the key aims of DRAS is to provide early supported discharge for selected patients admitted to hospital with an acute episode of respiratory illness. We work passionately to ensure patients and relatives are provided with expert support, advice and education to enable them to effectively manage their illness in their own home and improve their quality of life.

Other services provided:

Admission avoidance. We use safe and appropriate strategies to avoid admissions whenever possible.
Nurse-led clinics.
Support in consultant clinics.
Spirometry clinics to assist in the diagnosis of respiratory illness.
Interstitial lung disease clinics.
Asthma clinics.
Community multidisciplinary team meetings.
Facilitating hospital discharge for patients requiring oxygen.
Completion of COPD/asthma discharge bundles.
Training to healthcare providers for people with respiratory disease where necessary.
Liaison with the palliative care team, and support for patients and relatives who require palliative care and those experiencing deterioration in their quality of life with regard to physical, psychological, social and spiritual element of care.

Contacts:

Hospital respiratory team | Tel: 01384 244383 (internal: 3383) or bleep 7010
Monday to Friday, 8am – 6pm | Saturday to Sunday/BH, 8am – 4pm
Community respiratory nursing team | Tel: 01384 323193
Monday to Friday, 9am – 7pm | Saturday to Sunday/BH, 10am to 6pm

Home oxygen

We provide a home oxygen service to patients within and around the Dudley area who require home oxygen. This can be for many reasons, such as:

To facilitate early hospital discharge.
Chronic obstructive pulmonary disease (COPD).
Interstitial lung disease (ILD).
Asthma.
Palliative.
OSA with or without CPAP.
Oxygen advice and guidance with (NIV).
Cluster headaches.
Heart failure.

New referrals should:

Have a confirmed diagnosis.
Be receiving maximum pharmacological treatment.
Be in a stable state (no recent antibiotics or steroids) before being sent for assessment.
Have rest oxygen saturations of ≤92%.

The oxygen is a drug and is prescribed following a formal assessment in clinic. If a patient is admitted into hospital and is on home oxygen, they must not be discharged and advised to alter their own oxygen flow rate. When the home oxygen company visit to service equipment, they will return the oxygen flow rate to that which is on the official prescription.

Contacts:

Monday to Friday, 9am – 5pm (answer phone outside these hours) 01384 244315

Physiologists

The physiologist team at the Lung Function Unit provide a large variety of diagnostic investigations for patients in Dudley and neighbouring areas. These tests are primarily respiratory with some upper GI. These can lead to diagnosis and treatment pathways. Pre-operative assessments and long term monitoring of patients is often also required.

The team work with patients of mainly adult age and strive to create a welcoming and helpful environment for all patients, visitors and staff. The investigations are carried out in purpose built areas in a private and dignified setting. The team are highly trained to offer quality patient care whilst producing a variety of accurate and reproducible results.

Spirometry is the most common test procedure performed. This is carried out in a variety of clinical settings. These include wards, respiratory outpatient clinics and within the lung function unit labs.

Inpatient spirometry tests are conducted Monday to Friday from 9am until 12noon, and should only be requested via Sunrise. If your patient requires a clinically urgent spirometry in the afternoon, please contact the department directly to discuss on ext. 3167.

All test results are available on Sunrise once the procedures are completed.

Detailed pulmonary function tests are carried out within the lung function unit labs on specialist equipment. These tests can be requested by doctors within The Dudley Group NHS Foundation Trust.

All tests and procedures are conducted Monday to Friday, from 8.30am until 4pm.

List of available tests are given below:

Pulmonary function tests

Reversibility (MDI or Nebuliser)
Full Pulmonary Function Tests (Flow Volume Loops, Lung Volumes by Nitrogen Washout, Single Breath Transfer Factor)
Whole Body Plethysmography
Muscle Pressures

Exercise testing

6 minute walk
Shuttle walk
Bronchial lability
Cardio-respiratory

Other respiratory function

Arterial Blood Gas Sampling
Mannitol Challenge Testing
Hypoxic Inhalation Test

Gastro-intestinal tests

24 Hour ambulatory pH monitoring
Oesophageal Manometry
Hydrogen Breath Testing

Sleep service

The sleep service is located within the lung function unit and involves the diagnosis; treatment and long term follow-up of patients with obstructive sleep apnoea syndrome.

This includes overnight oximetry, detailed sleep studies and the setting up of continuous positive airway pressure (CPAP) treatment, as well as yearly follow-up and continued support of patients and equipment.

GPs can refer directly for sleep assessment via the e-referral Lung Function Open Access form. All results are reviewed and reported on by a specialist respiratory/sleep consultant. Patients requiring further investigation / treatment are then seen in a consultant led clinic before being referred to the physiologist team.

Long term nebuliser service

The Lung Function Unit is responsible for the maintenance of long term nebulisers issued by DRAS at the request of a respiratory consultant to patients within the community.

This involves medical device education to patients or carers, as well as yearly exchange of the machine and supply of essential consumables.

A weekly nebuliser maintenance clinic runs within the department. We do not offer home visits.

For more information or advice, contact:

Physiologists for general enquires – 01384 456111 ext. 3167
Lead physiologist – 01384 456111 ext. 3566 – Harry Patel (harry.patel1@nhs.net)

The Dudley TB Nursing Service consists of three nurses who specialise in caring for people with a diagnosis of Tuberculosis. We support the patients throughout their treatment which is six months minimum, but can be up to 12 months in some cases.

We also screen contacts to cases of TB in our nurse-led clinic at Guest Outpatient Centre on Mondays and Wednesdays.

Our clinic on Wednesday runs alongside the respiratory consultant Dr Doherty, where patients commence treatment for active or latent disease and we counsel those patients, informing them of side effects to treatment and offer support, which can be weekly home visits.

We administer BCG vaccination to those babies and adults who are eligible.

Our service accepts referrals from GPs, H/V and other health professionals. We are available to give advice and telephone consultations for anyone worried about TB in a workplace for example, however, we visit many settings and are always happy to provide any training.

If a patient is suspected of having TB, please contact the TB nurses as soon as possible on the following numbers:

Monday to Friday, 8.30am – 4.30pm
Office: 01384 321395
Mobile: 07717 815363

Lung cancer

The lung cancer specialist nursing service has four nurses who specialise in caring for people with suspected and a confirmed diagnosis of lung cancer. We support patients through their diagnostic pathway and if a diagnosis is confirmed through treatment and once treatment is completed. We work very closely with the lead clinician and nurse consultant for lung cancer, supporting patients in rapid access clinics. We also provide the same level of support for inpatients diagnosed on the wards at Russells Hall Hospital. We are a core member of the lung cancer multidisciplinary team, and act as the patients advocate and key worker. The specialist nurse role also includes the following:

Telephone helpline for patients and relatives.
Respond to email RAPA alerts informing the team that a lung cancer patient has been admitted to Russells Hall Hospital.
Admission avoidance where possible, and facilitating hospital discharge for patients.
Symptom control advice.
Provide nurse-led holistic needs assessment clinic.
Provide nurse-led palliative telephone clinic.
Support patients in oncology consultant clinic.
Liaison with the palliative care team and support for patients and relatives who require palliative care and those experiencing deterioration in their quality of life with regard to physical, psychological, social and spiritual element of care.
Education for health care practitioners caring for people with lung cancer.

The lung cancer team consists of: