A-Z of Services

Croydon Respiratory Team

  • The Croydon Respiratory Team (CRT) aims to improve outcomes for patients with chronic obstructive pulmonary disease (COPD) and Asthma in Croydon. It consists of a multi-disciplinary team of nurses, physiotherapists, support workers, administrators and doctors working in a variety of ways to achieve this aim. CRT is also able to provide home visits for patients who are housebound.

  • Base: The main service is at Croydon University Hospital and there are Croydon Respiratory Team services at other Trust sites.
  • Address: Croydon University Hospital 530 London Road, Croydon, CR7 7YE
  • Reception phone number: 020 8401 3974 option 2 option 2

COPD Admission avoidance

Before admission

Patients at risk of hospital admission due to COPD can be referred to CRT for rapid review and to attempt admission prevention using the generic CRT referral form on DXS (email to: ch-tr.crt@nhs.net).

Referrals are triaged by telephone, appropriate advice given and an appointment arranged as soon as clinically indicated. This can be a home visit on the same day if necessary. Patients are followed up to ensure advice and treatments have been effective.

During admission

CRT reviews patients identified in the ED (Mon–Sat, 9am–5pm) to help prevent unnecessary admissions. Rapid CRT follow-up in the community can be arranged to support safe discharge and ongoing management. CRT reviews all patients admitted with COPD and completes a COPD discharge bundle to optimise disease management.

After admission

All patients discharged following a COPD admission are contacted by CRT within 72 hours. Face-to-face follow-up is provided after discharge (unless significant risks are identified). This may be with a clinician or support worker, delivered at home or in clinic depending on the patient’s needs and risk profile.

Pulmonary rehabilitation

Pulmonary rehabilitation is a twelve-session programme of individualised exercises and education. It is designed to help people with limiting symptoms caused by chronic lung disease to manage their condition better.

Benefits include reduced breathlessness on daily activities, increased walking distance, increased control of symptoms and reduction in hospital admissions. The exercises are tailored to individual ability levels and increase muscle strength and fitness levels over the duration of the course

The weekly education talks help patients improve knowledge of their condition and how to help themselves.

The service is run by a team of specialist physiotherapists and exercise instructors. At the end of the six weeks, graduates are helped to plan exercise in their daily lifelong term and are provided with a Home Exercise Programme.

The pulmonary rehabilitation programme is provided in a variety of community locations around the borough.

We carry out our assessments and classes at:

Purley Christ Church Hall - Purley Christ Church Hall, 861 Brighton Road, CR8 2BN   (Tuesday and Thursday pm)

Croydon University Hospital - 730 London Road, Croydon, CR7 7YE (Tuesday am and Friday pm)

St Mildreds Church, 30 Bingham Road, CR0 7EB (Monday pm and Friday am)

 

How to refer

Email the generic CRT referral form found on DXS to ch-tr.crt@nhs.net

Contact information

Catherine Smallwood / Kim Nottingham (Respiratory Physiotherapists & Team Leaders)

Tel: 020 8274 6495

Email: ch-tr.croydonpr@nhs.net

Structured Education Programmes for patients

CRT deliver group education courses for patients diagnosed with asthma (ASHLEY) and COPD (CASSIE) who are registered with a Croydon GP.

ASHLEY and CASSIE are important for anyone with a confirmed diagnosis of asthma or COPD and will help them to understand their condition better. We know that early disease education can slow down the progression of respiratory conditions and help patients stay well and avoid hospital admissions.   We discuss physiology, disease management, inhaler techniques, recognising worsening symptoms, exacerbation management and the importance of exercise.

The courses are run by a respiratory clinician and an educator, consist of 2 sessions, which last 3 hours and are held one week apart.   These are delivered in person in a variety of locations across Croydon or online via Microsoft Teams.

How to refer

Email the generic CRT referral form found on DXS to ch-tr.crt@nhs.net

Contact Information

Tel: 020 8401 3974 option 2, option 2

Email: ch-tr.crteducation@nhs.net 

Asthma nurse led clinics

During Admission

CRT reviews all adult patients (over 18) admitted or attending the ED with an exacerbation of asthma, completing an asthma discharge bundle to optimise disease management.

After Admission

All patients discharged after an admission for asthma are offered a follow up appointment in clinic with an asthma nurse specialist within approximately a month of discharge (mainly video follow-ups, some face-to-face appointments available.)

Patients at high risk of admission (3 or more ED attendances in the previous 12 months) will also be offered a follow up appointment in clinic with an asthma nurse specialist.

How to refer

Email the generic CRT referral form found on DXS to ch-tr.crt@nhs.net

Contact Information

Tel: 020 8401 3974 option 2, option 2

Email: ch-tr.crtasthma@nhs.net

Home oxygen service and review

The CRT reviews all adults registered with a Croydon GP with an oxygen prescription (HOOF) regardless of diagnosis. The majority of patients under our service have an underlying respiratory or cardiac condition.

About the service

The HOSAR Service is delivered by CRT Specialist Practitioners and Assistant Practitioners. We are responsible for the assessment and review of patients who may need oxygen or for those that already receive oxygen therapy at home.

If you have been prescribed oxygen you will be reviewed by our team regularly. The team is happy to assist where possible and happy to provide expert advice.

Oxygen therapy is NOT a treatment for breathlessness in the absence of chronic hypoxia (low oxygen in the blood).

Oxygen is NOT prescribed to those who are current smokers or vapers or to those that have smoked / vaped in the last 6 months. Reference: BTS Guidelines for Home Oxygen Use in Adults (2015)

 

What we do

We assess for Long Term Oxygen Therapy (LTOT) and Ambulatory Oxygen (AO), as per National Guidelines. We ensure that all patients have the correct oxygen prescription, appropriate to the individual at that moment in time.

These assessments are either taken place in a patient’s home or in an oxygen clinic at Croydon University Hospital. Each patient that is prescribed oxygen will be closely monitored by our team.

 

Prescribing LTOT

Patients with low oxygen levels (chronic hypoxaemia) may meet the criteria for LTOT (using oxygen for a minimum 15 hours of the day.)

We will assess patients for LTOT if their resting saturations are consistently below 92%. This must be seen following a period of clinical stability of 6 weeks, ensuring that patient is medically optimised which includes being on maximal inhaled therapies, having co-morbidities optimised, having attended pulmonary rehabilitation and following appropriate stop smoking treatment.

Patients will only be assessed if they are deemed safe to have oxygen therapy at home and that all risks have been mitigated such as hoarding, falls, smoking or confusion.

 

Palliative Oxygen

If a patient is approaching the end of their life, it may be suitable for a clinician to commence oxygen therapy based on an individual assessment.  We are happy to provide advice regarding the Home Oxygen Order Form (HOOF) completion in these circumstances but the prescription is usually led by the Palliative Care Specialist or GP.

 

Home oxygen ordering

HOOF A is for non HOSAR HCPs to order home oxygen in an EMERGENCY before specialist assessment. A HOOF A will only allow the temporary ordering of static oxygen i.e. an oxygen concentrator, and not portable cylinders.

HOOF B can ONLY to be completed by the HOSAR service after formal assessment.

Part A prescription (HOOF-A)

The home oxygen provider in London is Baywater and orders are placed via their online portal https://apps.baywater.co.uk/Account/Login?ReturnUrl=%2f

Clinicians who need to submit a HOOF A will need to register via the Batwater portal using and nhs.net email account. The process is straightforward and should only take a few minutes.

It is essential that an Initial Home Oxygen Risk Mitigation form (IHORM) and Home Oxygen Consent Form (HOCF) are completed before the oxygen can be ordered. These need to be signed by the patient or carer and need to be uploaded to the patient’s medical records.

If you need further guidance, a copy of the HOOF Part A - Portal User Guide is available to download Baywater Online Portal

If you encounter any problems, please contact Baywater customer services team on 01270 218 050 or via email: healthuk@baywater.co.uk

 

Accessing the CRT HOSAR Service

Referrals to the Home Oxygen Service can only be made by a registered clinician via the generic CRT referral. Referrals that do not have the required clinical information to appropriately triage or meet criteria will be rejected and further information requested.

Please note that we do not have an urgent oxygen service. Patients will be reviewed within 10 working days.

If a patient is already on oxygen, you do not need to complete a formal referral but please contact us directly, ideally by telephone, to discuss.

 

How to refer

Email the generic CRT referral form found on DXS to ch-tr.crt@nhs.net

 

Contact Information

Tel: 020 8401 3974 option 2, option 2
Email: ch-tr.crt@nhs.net

Community nurse-led clinics

A number of practitioner-led respiratory community clinics are available each month. CRT provides these reviews to provide an alternative location for patients (to being treated in their own home.) The appointments can be utilised for patients post discharge from hospital or for patients referred into the service to optimise COPD disease management.

How to refer

Email the generic CRT referral form found on DXS to ch-tr.crt@nhs.net

Patients are offered the next available slot (usually within 1-2 months.)

Contact Information

Tel: 020 8401 3974 option 2, option 2
Email: ch-tr.crt@nhs.net

Clinicians

Dr Roshan Siva
Consultant Physician

Dr Yogini Raste
Consultant Physician

Amy Grant
Service Manager for Croydon Respiratory and Integrated Cardiac Rehab Teams

Sally Newsome
Croydon Respiratory Team Lead and COPD Clinical Specialist

Chandra Yagambrun
Croydon Respiratory Team Lead Asthma Clinic Nurse Specialist