Abstract

Overview:
From the earliest stage of the COVID pandemic in March of 2020, respiratory diagnostic services were significantly impacted leading to protracted delays in confirming a respiratory diagnosis in Primary Care.
As the restrictions began to ease late in 2021 additional issues began to emerge, loss of experience and competences with a lack of update training was further compounded by a natural decline in the experienced HCP workforce through retirement and role changes amongst other factors.
It was agreed that a bespoke local diagnostic service should be considered tin conjunction with a unique mentorship programme aiming to help address this ever-increasing challenge. The diagnostic service that was subsequently developed was fully compliant with all elements of the ARTP standards and was adherent to local and national infection control policies; whilst also factoring in the ever-evolving changes in Local Government legislation. and not only offered patients the opportunity to have a holistic assessment and potentially confirming an accurate diagnosis but in addition HCPs were afforded the opportunity to avail of a unique mentorship service aiming to rebuild their competencies and confidence to restart their services.

The Hub was based in a purpose ‘built’ room in the Ormeau Health Centre, with a HEPA air filtration system installed and sneeze screen mounted on a table to offer further protection to both the patient and nurse.

The diagnostic service components included:
• Taking a full clinical history
• Conducting a full clinical assessment and chest examination
• Dyspnoea assessments to include: SPO2, Pulse (manual), Respiration rate, BORG scores at rest and OE
• Weight, height – BMI
• Smoking and Noxious particle exposure
• Haematology & biochemistry analysis amongst others as indicated
• ECG and chest X Rays
• Base and reversibility spirometry testing, with accurate interpretation of the results
• FeNO testing as appropriate
• Writing up the findings – including the confirmed diagnosis when possible, in con junction with suggested pharmacological and non-pharmacological management and /or further assessments or onward referral if indicated
• Offering of training and mentorship to all relevant HCPs to help others reinstate their own respiratory diagnostic services