Introducing respiratory support units in all NHS hospitals will transform respiratory care for staff and patients

From our annual Winter Meeting, we have called for the NHS to officially recognise, roll out and adequately fund the Respiratory Support Unit model across the UK.

Respiratory Support Units (RSUs) are an increasingly recognised way to deliver care to people admitted to hospital with severe lung disease that need enhanced respiratory support.  They emerged as one of the respiratory community response to the demands of the pandemic, and have been further refined into a robust and standardised model by the British Thoracic Society in collaboration with the Intensive Care Society.

They are designed to be based within respiratory wards, staffed by specialists in all aspects of acute respiratory care, in particular non-invasive ventilation, with access to dedicated space and oxygen infrastructure, and will work closely with Intensive Care departments.

RSU-like arrangements are already operating across the country to provide respiratory support for patients with COVID-19 outside the critical care environment, saving intensive care capacity. For months now, respiratory teams across the UK have been providing enhanced respiratory support to COVID-19 patients, using techniques that include high flow nasal oxygen (HFNO) and continuous positive airway pressure (CPAP) on dedicated areas of their wards.

Their impact has been mentioned by NHS Getting it Right First Time as excellent practice in a recent report, which also supports their application beyond the pandemic.

Once officially adopted, RSUs will transform respiratory care, and will be particularly useful to cope with the winter pressures and the ongoing presence of endemic COVID-19. When hospitals face the seasonal increase in emergency visits, which we know are predominantly related to respiratory illness, respiratory support Units will strengthen the ability of hospital teams to meet these annual challenges. The new Units can prevent the need to divert resources from in- and outpatients clinics and specialist services.

Professor Jon Bennett, Chair of BTS said:

“Respiratory Support Units must be every hospital’s centre of excellence in respiratory care.

“It’s imperative that they are officially recognised, supported and adequately funded so that they can outlive the COVID-19 pandemic. They need robust standard operating policies and the appropriate workforce from the start, as well as funding to run them.

“We know that the skills already exist in our NHS, however the numbers do not. So we also need a commitment to increase the size of specialised respiratory workforce.

“I really hope these will become one of the most positive and lasting legacy from this awful pandemic.”