Local Respiratory Diagnostic Hublets (RDH) offer essential respiratory tests, including spirometry and FeNO, to enhance diagnostic processes in primary care. Local referral routes, requirements and wait times will apply, so check with your hublet or primary care network lead.

Multidisciplinary teams (MDT) are available or being stood up in each borough to support with the diagnostic algorithm and uncertainty or complex cases. Contact your federation lead to be given access to MDTs. (Clinicians attending MDTs should be ready to present traces and case history for discussion.)

Please note: for children and young people (CYP), a peak flow diary excel template with support for peak expiratory flow calculations is available on request, email Lauren Gillings for this. 

If you have queries about the overall (system-wide) hublet services, contact lauren.gillings1@nhs.net.

Eligibility Criteria

Inclusions

Before referral, refer to the appropriate age diagnostic algorithm (see Downloads) to ensure appropriate case management. 

Referrals to the RDH will be accepted for patients registered at an NCL GP, or not currently registered with a GP but signposted by services such as homeless teams as follows:

• FeNO available age 6+
• Spirometry available: 
  • 12+ universally
  • 6-11 only where paediatric-accredited staff are available (subject to local training completion) 

Plus any of the following:

• symptoms and clinical presentation consistent with Asthma or COPD and diagnostic testing required
• historic diagnosis of suspected asthma or COPD and diagnostic confirmation needed. Such individuals will be prioritised according to clinical need. Some patients will already be on treatment for asthma or COPD which may need review prior to diagnostic testing
• confirmed diagnosis of COPD or asthma but is experiencing unexpected deterioration in symptoms or change in exacerbation rate requiring diagnostic confirmation.

Exclusions

• Routine spirometry or FeNO for case-management (this service is, at present, for diagnostic spirometry)

How to Refer

Local referral processes apply. If you are unable to access your local form via EMIS or have further queries, contact your primary care network (PCN) lead or operational lead noted below.