The Impact of a new Rapid Response Children’s Respiratory Physiotherapy Service for Children with Long Term Complex Physical Disabilities – A Service Evaluation of a 12-month pilot.

Background:Severely disabled children are at increased risk of hospitalisation because of chest infections.Providing specialist respiratory care to these children may help to reduce morbidity, mortality, and rates of hospitalisation.The Children's Rapid Response Respiratory Service aims to provide early specialist assessment and rapid treatment within 24 hours of onset of respiratory concern in the community as well as provision of a chest care plan, regular review, and parent/carer training throughout the year.The aim of this service evaluation was to examine the impact of a 12-month pilot Children's Rapid Response Respiratory Service on children and young people with complex physical disabilities. Methodology:Children and young people aged 0-19 years of age, with long-term physical disabilities, who were registered with a Lincolnshire GP practice, were eligible for the service.The Gross Motor Function Classification Scale (GMFCS) was used to classify physical disability eligibility (Palisano et al. 2007): all children classified as GMFCS level V as well as those classified as GMFCS level IV who incurred repeated chest infections were included.The number and length of hospital admissions over 12 months were collected retrospectively 12 months prior to the pilot start date and prospectively for 12 months after the start date.Additional data collection included: number of out of hour attendances with general practitioners (GP) and at Accident and Emergency departments (A&E), number and graded impact of rapid response interventions, anticipated cost savings and service user feedback.