Respiratory Diagnostic Hublets (RDHs)

Provided By

Enfield GP Federation, provider for Respiratory Diagnostic Hublets (RDHs)

Haringey GP Federation, provider for Respiratory Diagnostic Hublets (RDHs)

Camden Health Partners

Islington GP Federation, provider for Respiratory Diagnostic Hublets (RDHs)

Please note: This page is in the process of being updated. Further information will be added in due course.

Respiratory Diagnostic Hublets (RDHs) are local diagnostic centres in primary care, bringing respiratory testing closer to communities.

Designed to reduce waiting times and improve access, each hublet offers essential tests like spirometry and FeNO. They are staffed by trained professionals to provide quality assured diagnostics. Staff in hublets will have or be working towards their ARTP accreditation. The hublets are intended for use for first-line diagnostics. Local referral routes, requirements and wait times will apply, so check with your hublet or PCN lead if you are unsure on local practice.

Referrals to RDHs have criteria outlined below. Please note eligibility for specific age groups:

Registered at an NCL GP, or not currently registered with a GP but signposted by services such as homeless teams.
Patients identified as in need of diagnostics via case-finding activity
Patients presenting as newly symptomatic requiring diagnostics

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 or those who do not have quality assured spirometry (e.g. handheld only).

MDTs 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. Please note: clinicians attending MDTs should be ready to present traces and case history for discussion.

The diagnostic algorithms and hublet model have been developed in line with NICE guidance and local requirements.

Contact details

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

Please note: for CYP, a peak flow diary excel template with support for PEF calculations is available on request, email Lauren for this.

If you have a locality-specific query, please note the following contacts:

Barnet: Michael Whitworth / Ross Arnold (michael.whitworth@nhs.net / ross.arnold1@nhs.net)
Camden CHE: Rebecca Maynard (nclicb.che.group@nhs.net / rebecca.maynard4@nhs.net)
Camden CHP: Jenny Papaeliopoulos (j.papaeliopoulos@nhs.net)
Enfield: Renata Chavda / Lee Stephenson (renata.chavda@nhs.net / lee.stephenson5@nhs.net)
Haringey: Charlotte Defries (charlotte.defries@nhs.net)
Islington: Edel Moallin (edel.moallin@nhs.net)
Islington North Only: (biana.gonclaves@nhs.net)

Eligibility Criteria

Inclusions

Prior to referral, refer to the appropriate age diagnostic algorithm (available as PDF at the bottom of this page) to ensure appropriate case management.

Age requirements

For the adult service:

Aged 18 and above. Note children over the age of 12 may be tested by clinicians with adult ARTP accreditation. ARTP accreditation is not needed for FeNO testing.

For the children and young people service:

aged 6+ for FeNO
aged 12+ for spirometry in all services.

Important: for patients aged 6-11 years, spirometry access is not available as required accreditation is undertaken by hublets staff. Please utilise recommendations in the diagnostic algorithm attached at the bottom of this page.

Exclusions

Routine spirometry or FeNO for case-management (this service is, at present, for diagnostic spirometry)
Note: patients should be assessed by referrers with consideration to their ability to perform diagnostic tests.

How to Refer

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