HOME FIRST Pilot: a Study of Early Supported Discharge in Patients With Lower Respiratory Tract Infections

Eligibility - Patients with any of the following conditions; * Pneumonia - community-acquired (CAP) or hospital-acquired (HAP) - pneumonia definition - a series of clinical symptoms with radiological consolidation N.B. All pneumonia CURB-65 scores will be considered but patients with CURB-65 ≥3 MUST have had at least 24hrs of in-patient observation before recruitment into part B of the study. * Pneumonia with concomitant COPD or bronchiectasis * Non-pneumonic lower respiratory tract infection without COPD or bronchiectasis Inclusion Criteria: * Age\>18yrs old * All observations must be stable for 12-24hrs * EWS ≤2 AND SBP\>90 (all observations must be stable for 12-24hrs) * Has a telephone * Can manage activities of daily living with current available support (If needed, immediate occupational therapy/physiotherapy/social assessment and care can be arranged prior to discharge and continued at home) * Improving/stable inflammatory markers * Improving/stable U\&Es * Fluent English speaker Exclusion Criteria; * Acute exacerbations of COPD * Acute exacerbations of bronchiectasis without consolidation * Patients with CURB-65 \>3 admitted \<24 hours ago * Patients unable to manage at home even with maximal support from HOME FIRST (This may include intravenous drug users, patients with history of excess alcohol consumption or mental health problems) * Empyema or untapped pleural effusion (If no diagnostic pleural tap performed - discuss with study doctor) * Serious co-morbiditi…