Reviewed on : 18 Aug 2025

Reviewed by : Joanna Purvis and Vicky Moore

Expires : 18 Aug 2027

About the Breathlessness Pathway

The Physiological Science Services (Respiratory & Sleep Physiology Team) within the Warwickshire North Community Diagnostic Centre and the Rugby Community Diagnostic Centre provide the Breathlessness Pathway

A symptom-based pathway with aim to improve and streamline respiratory diagnostic services

Delivered by a team of clinical scientists with specialist clinical training in the speciality of respiratory and sleep medicine

A one stop clinic approach combining multiple diagnostics, clinical consultation, and therapy plan to patients with either an unclear diagnosis or disproportionate symptomatology

Promoting efficiency, reduced hospital visits, reduced waiting times, improved resilience within the Medical Team and improves clinic availability within Respiratory Medicine for access to specialist service such as bronchiectasis clinics and pulmonary fibrosis patients

Assessment at the Breathlessness Clinic

• Full clinical history review
• Observations and appropriate diagnostics
• Discharge back to the GP with advice, management by the Physiology Team, referral for consultant review, or referral to other specialist services as appropriate

Advice & Guidance and Multi-Disciplinary Forums

As part of the new breathlessness clinic, we will also be offering an advice and guidance service

Our aim is to work collaboratively with primary care to improve patient care and management of their respiratory condition

Multi-disciplinary forums where we invite primary care providers to discuss their patient where there is any doubt, queries or concerns regarding patient outcome or on-going management of their condition

Possible Causes of Breathlessness

Cardiac:

• Heart failure
• Angina/IHD
• Valvular heart disease
• Arrythmias

Mental Health:

• Depression
• Anxiety

Other:

• Anaemia
• Chronic Kidney Disease
• Thyroid disease

Fitness/Deconditioning:

• Low fitness level
• Obesity
• Frailty

Respiratory:

• Asthma
• COPD
• ILD
• Pleural disease
• Pulmonary hypertension

Indications for Referral

Breathless Pathway Referral – assess for Red Flag symptoms and follow red flag recommendations if concerns arise

Red flags – Referrals will be rejected

• Consider 2ww
• Consider urgent/ emergency care

Investigations

How to refer:

Referrals for North Warwickshire can be made via the electronic referral system (e-RS): Community Diagnostic Centre: Breathlessness (chronic/ undiagnosed)

Patients may be accepted from Coventry and South Warwickshire subject to available capacity and pending establishment of further local services

Referrals for the Rugby and South Warwickshire area (including Postcodes CV21, CV22, CV23, Rugby, CV47 Southam, NN11, NN6 Northampton, CV8 Kenilworth, CV3, CV7 Coventry) can be made via electronic referral system (e-RS): Respiratory Community Diagnostic Centre: Community Rugby St Cross or via email to: respiratorycdc@uhcw.nhs.uk.

Contact

• North Warwickshire Contact

Joanna Purvis Physiological sciences service manager Clinical scientist – Respiratory and Sleep

Community Diagnostic Centre George Eliot Hospital Warwickshire North Place

Email: respiratory.physiologists@geh.nhs.uk

• Rugby Contact

Vicky Moore Consultant clinical Scientist, Respiratory and Sleep

Community Diagnostic centre, Rugby St Cross Hospital

Email: respiratorycdc@uhcw.nhs.uk