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G526(P) A service evaluation of rapid response domiciliary respiratory physiotherapy in children with complex needs
  1. Z Johnstone1,
  2. D Urquhart2,
  3. L Noone1,
  4. E Dhouieb1
  1. 1Physiotherapy, Royal Hospital for Sick Children, Edinburgh, UK
  2. 2Respiratory Medicine, Royal Hospital for Sick Children, Edinburgh, UK


Aims To evaluate clinical and cost effectiveness of a rapid response respiratory physiotherapy service in the community.

Methods Prospective review of frequently admitted children with complex needs and recurrent respiratory infections. Data on A+E attendances, hospital admissions and length of hospital stay were gathered for 2009 (year prior to introduction) and for three years of the intervention (2010–12 inclusive). Data for 2013 (physiotherapist on maternity leave and service suspension) and 2014 (return of service after maternity leave) were also collected.

Results Data from 17 paediatric patients aged between 2 and 15 years with a variety of neurodevelopmental and muscular disorders were analysed. Initial data review in 2012 demonstrated a 60% decrease in A&E attendances, 62.5% decrease in admission numbers and a reduction of 174 bed days per year on average compared with 2009, equating to a net cost saving of £114,318

Data for 2013 (service suspension) saw A&E attendances and hospital admissions increase back towards baseline. The return of the service in 2014 saw A+E attendance again falling 40% from baseline, admissions dropping by 25% and length of hospital stay being reduced by 108 days from baseline with a total net saving estimated at £70,956

Conclusions These data demonstrate the positive impact of a community-based specialist respiratory physiotherapy service in reducing A&E attendances, hospital admissions and length of hospital stay. This not only reduces hospital pressures, improves parent and carer satisfaction but also demonstrates significant cost savings to the NHS.

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