About the Respiratory Diagnostic Service across Coventry & Warwickshire
Reasons for referral:
- Unexplained shortness of breath
- Unexplained cough
- Inconclusive spirometry (please include a copy of recent spirometry)
- Disproportionate breathlessness
- Abnormal CXR (not suspicious for cancer, TB or current infection)
- Suspicion of Asthma COPD Interstitial Lung Disease (ILD)
Services provided:
- Full Pulmonary Function (spirometry, lung volumes, gas transfer, FeNo, SpO2)
- Full Pulmonary Function and Bronchodilator Responsiveness
Coventry Guidance 
Respiratory Diagnostic Service (Community Diagnostic Centre)
As part of the development of a community diagnostic centre, UHCW NHS Trust launched a respiratory diagnostics service in February 2022. This is for Coventry and Rugby patients and is available by eReferral.
Reasons for referral:
- Unexplained shortness of breath
- Unexplained cough
- Inconclusive spirometry (please include a copy of recent spirometry)
- Disproportionate breathlessness
- Abnormal CXR (not suspicious for cancer, TB or current infection)
- Suspicion of Asthma COPD Interstitial Lung Disease (ILD)
Services provided:
- Full Pulmonary Function (spirometry, lung volumes, gas transfer, FeNo, SpO2)
- Full Pulmonary Function and Bronchodilator Responsiveness
Pre Referral Considerations:
Please use referral form provided (see below and link right)
It is expected that all patients referred for respiratory diagnostics will already have undertaken spirometry testing.
Could symptoms be due to lung cancer or TB? (Consider red flag symptoms and a chest X-Ray).
Could symptoms relate to heart failure? (Consider chest X-ray and BNP).
Where asthma is suspected ensure spirometry with bronchodilator responsiveness has been performed.
Patients able to undertake capillary blood gas testing and/or six minute walk assessments.
GP and patient agree to onward referral to other UHCW Teams if clinically indicated.
Referral Pathway
Referral Form
Click on Referral Form Link right for the centre of your choice
Please ensure that the form is signed to allow administration of salbutamol
North Warwickshire Guidance
Respiratory Diagnostic Centre (CDC) at George Eliot Hospital
Update February 2024: Hand written referrals
As of Monday 19th February 2024 the Cardio-Respiratory Unit/ Community diagnostic centre will no longer accept hand written referrals. We receive a significant number of hand written referrals that either have incorrect patient demographic information or are illegible leading to incorrect patient information being registered. This will include the following referrals:
- Respiratory Diagnostic referral
- Assessment of sleep disordered breathing
- Home oxygen therapy
- Breathlessness clinic
- Echocardiography
Referral guidance:
Prior to referral where asthma is suspected:
- Please perform spirometry with bronchodilator response if required if available
- Patient to complete a two week, twice daily peak flow diary
- Full blood count and total IgE
- Consider whether patient symptoms are cause by cancer or TB
- Consider red flag symptoms and request urgent chest x-ray
- Could patient symptoms be related to heart failure (consider CXR ECG and blood tests – check BNP levels >100 pg/mL suggestive of heart failure)
Reasons for referral:
- Unexplained breathlessness
- Unexplained cough
- Inconclusive spirometry (Please include most recent spirometry results if applicable)
- Disproportionate breathlessness
- Suspected airway or interstitial lung disease (Asthma, COPD, Bronchiectasis,
- interstitial lung disease)
- Poorly controlled or severe asthma
- Abnormal CXR (not suspicious for cancer, TB or current respiratory infection)
Referral Pathway
Services provided:
- Spirometry
- Spirometry and bronchodilator response
- FeNo
- Full Pulmonary Function (spirometry, lung volumes, gas transfer)
- Full Pulmonary Function and Bronchodilator Responsiveness
- All patients will have oxygen saturations checked and if SpO2<94% blood gases performed
By completing the patient referral both referrer and patient agree to further referral to other available services if clinically indicated. These may include but not limited to:
- Mannitol challenge testing
- Nijmegen questionnaire
- Blood gases
- Cardiopulmonary exercise testing
- Referral to respiratory medicine
- Referral to other speciality as appropriate
For review soon
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Rugby & South Warwickshire
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