REMEDY : BNSSG referral pathways

Pleural Services

Checked: 16-10-2018 by vicky.ryan Next Review: 16-10-2019

Service Overview - NBT

The pleural service aims to prevent patients being admitted for unnecessary inpatient stays by facilitating rapid therapeutic and diagnostic pleural aspirations prior to further fast track investigations as an outpatient. This approach has managed to keep 93% of new pleural effusions as outpatients (data from pleural service)

They are able to offer patients: - A daily (Monday - Friday) admission avoidance pleural clinic (2-3pm) on the Medical Day Unit.

Patients are seen the same or next day with new effusions or known pleural disease threatening admission. 

Referral Guidance - NBT

Any patient with symptomatic unilateral pleural effusion where an intervention will avoid hospital admission or allow fast track investigations into the underlying cause. These clinics are unsuitable for patients who are acutely unwell or bedbound.

Please include anti coagulation information in any correspondence as this may influence the timing of interventions.

Referrals should be discussed with the Pleural SpR on 07894 803088 then email the referral to Pleural-Referrals@nbt.nhs.

Patients will be seen the same or next day with new effusions or known pleural disease threatening admission. 

Service Overview - UHB

The clinic is set up to prevent admission of patients with pleural effusions and other pleural diseases.

Whilst the majority of patients are expected to have pleural effusions, the clinic is for patients with all forms of pleural disease such as pneumothraces, pleural thickening, etc. The time slots are flexible and allow us to perform diagnostic and therapeutic aspirations which previously required admission.

The clinic is every Wednesday morning. We will endeavour to see all patients the Wednesday after they are referred with the deadline being Tuesday 13:00 unless discussed with the consultant in charge.  If the clinic is full, priority will be given to those who need symptomatic relief to avoid admission and patients referred in the 2 week wait category.

Please ensure that the patient contact telephone number is included on the form. We will contact them by phone to give an appointment time.

If referring patients for a procedure please ensure that they are aware of this and that they may be in the department for some time.

Referral Guidance - UHB

Refer using the Pleural Clinic Referral Form (word doc).  Referrals should be faxed to 0117 342 2921

Inclusion Criteria:

  • Any adult patient with pleural disease that needs investigating.  This includes pleural effusions, pneumothorax follow-up, pleural thickening.

NB:  The clinic is set up to perform diagnostic pleural taps and therapeutic pleural aspirations.  Any patient requiring a procedure must be physically capable of sitting on edge of trolley independently whilst procedure is performed.

Exclusion Criteria:

  • Patients who are systemically unwell

For Advice - The Respiratory Nurse Specialists can be contacted on 0117 342 4101