Referrals from the General Practitioner
Patients can also be referred into the HITH programme by their General Practitioner. This referral pathway is different from that of the Hospital inpatient or emergency department in that all referrals from the GP will need clinical assessment at the HITH assessment centre based at the Beacon Hospital in Sandyford. The reason for this is General practitioners do not have ready access to the diagnostic tests required to categorically include or exclude a patient in accordance with the inclusion and exclusion guidelines.
Currently when a patient presents to their GP the Doctor has no alternative but to send the patient to the local emergency department for assessment and further treatment if warranted. HITH will allow patients presenting to the GP with certain conditions to avoid A+E departments completely by accessing the relevant diagnostic procedures through the HITH programme and receiving their treatment at home.
The Following Clinical inclusion and Exclusion criteria apply to all referrals:
Inclusion Criteria
The following will be applied:
- Diagnosis of acute infective exacerbation of COPD / uncomplicated pneumonia or other agreed conditions treated by the HITH programme.
- Patient willing to be treated at home.
- Patient (or carer) has access to the telephone and relevant social support.
- Home accessible to homecare team.
- General Practitioner supportive of inclusion in programme.
- Consultant / NCHD supportive of inclusion in programme.
Exclusion Criteria
Presence of high-risk co-morbid conditions, including:
- New onset chest pain.
- Non responding or complicated pneumonia.
- New onset cardiac arrhythmia.
- Uncontrolled congestive heart failure.
- Uncontrolled diabetes mellitus.
- Acute or decompensated renal or liver failure.
Detailed GP referral protocols are attached at the back of this booklet.