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Respiratory

The Respiratory department offers a full inpatient and outpatient medical service, to treat adults with conditions affecting the respiratory tract, including asthma, chronic obstructive pulmonary disease (COPD), lung cancer, respiratory infections and bronchiectasis, tuberculosis (TB), interstitial lung disease and sarcoidosis, pleural disease and sleep disorder.

Diagnostic facilities are also provided for the majority of respiratory conditions.

Bedford Hospital

The Chest Clinic treats and cares for patients with any respiratory disease or suspected respiratory problems. On average the Clinic sees 4500 patients per year. The clinic has facilities for investigations such as spirometry, oximetry, skin allergy tests, chest x-ray, sleep studies, CT scans, and fibreoptic bronchoscopy. We also have a modern pulmonary function laboratory.

Outpatients are seen at Bedford Hospital Chest Clinic, which is located in Ombersley House at the South Wing site. Dr Azher and Dr Thomas read all referral letters and, taking into account both the clinical details and the GPs request, will specify the priority of the appointment.

Staff

Dr Sunil Krishnankutty Consultant in Acute Medicine and Respiratory Medicine
Dr Amer Saleem Chest Physician
Luton and Dunstable University Hospital

The Respiratory department is supported by eight full-time consultants, an associate specialist, four full-time respiratory physiologists, six full-time respiratory nurse specialists, one extended scope physiotherapist and two full-time lung cancer nurse specialists with additional support from two TB nurse specialists. There is also a visiting Cardio-Thoracic Surgeon who comes across from Harefield Hospital every week.

The department also has close links with the community based respiratory nurse specialists, Macmillan palliative care nurses and community matrons. The department is currently expanding with the imminent appointment of additional consultants in order to further improve and expand the services available.

The Luton and Dunstable University Hospital has excellent tertiary links with Mount Vernon, Harefield, Addenbrookes, Papworth and the Royal Free and Royal Brompton hospitals in addition to St Marys Hospital London.

Services we offer

  • Acute Respiratory Assessment Service (ARAS) – this is an urgent service for patients with chronic lung disease (COPD/ILD/Bronchiectasis) who are having a flare up that is not responding to antibiotics or steroids. Patients and healthcare professionals can refer into this service
  • Early Supported Discharge (ESD) – this service allows patients with chronic lung disease to potentially be discharged from hospital admission earlier with support from the Respiratory team at home for a few days. Patients can be discharged with nebulisers/oxygen if appropriate.
  • Home oxygen service – Patients who are found to have low oxygen levels can be assessed to see if they will benefit from home oxygen (please note there are strict criteria around the provision of home oxygen, particularly regarding smoking). Once a patient is started on oxygen, they will be followed up regularly, initially at home and then in clinic/by telephone.
  • Sleep Service
  • Pulmonary Rehabilitation
  • Physiology services:
    • Full lung function and exhaled nitric oxide
    • Provocation testing
    • Sleep Studies
    • Flight assessments
    • Oxygen assessments
    • Manometry studies
  • Bronchoscopy with lavage endobronchial biopsies, transbronchial biopsies and transbronchial needle aspiration
  • Pleural aspiration and biopsy
  • Endobronchial ultrasound transbronchial needle aspiration (EBUS)
  • Skin prick testing for allergy profiling

Specialist Clinics

  • Lung cancer clinic
  • TB clinic
  • Interstitial lung disease clinic (consultant and nurse specialist joint clinic)
  • Bronchiectasis clinic (consultant and specialist physiotherapist joint clinic)
  • Pleural clinic
  • Asthma clinic (specialist nurse clinic)
  • Community COPD clinic (specialist nurse clinic)

Specialist Multidisciplinary Teams

  • Interstitial Lung Disease MDT – Respiratory consultants, consultant radiologists and respiratory nurses meet to discuss and review imaging of patients with suspected or confirmed ILD to determine diagnosis and ongoing management.
  • Non-malignant MDT – This is led by one of the Respiratory consultants and involves respiratory nurses from the hospital and community, members of the Keech Palliative Care Centre, psychology/wellbeing services, pulmonary rehabilitation, community matrons and GPs. The team looks at what support and management can be given to those patients who are struggling with symptom management as a result of their progressive chronic lung condition, in order to help improve quality of life and reduce hospital admissions.
  • Transition MDT – We are aware that the process of transitioning from paediatric to adult services can be quite daunting, so in respiratory we have set up a transition MDT which involves paediatric and respiratory consultants, paediatric and adult respiratory nurses, as well as the patient and carers. Patients with ongoing respiratory conditions that will need managing by adult services are aimed to be reviewed in the joint clinic from the age of 16 upwards until they have fully transitioned to adult services.
  • Sleep MDT
  • Lung Cancer MDT

Inpatient Services

  • Ward 10 (Respiratory Unit) – we have a dedicated respiratory ward which is covered by two respiratory consultants as well as a respiratory nursing team.
  • Respiratory HDU – We have a dedicated respiratory HDU for patients that require non-invasive ventilation. This unit is covered by one of the respiratory consultants.
  • Respiratory In-reach – Respiratory consultants will review patients admitted due to respiratory causes on the admission wards – this enables specialist assessment and treatment early on during an admission and allows us to appropriately arrange the transfer of patients to respiratory HDU or the respiratory unit (Ward 10)
  • Yellowboard – Other ward areas can ask for respiratory review for patients that they have concerns about.

Conditions we treat

Staff

Beverley Gardner Admin Lead and Secretary to Dr Ramsay
Dr Timothy Chapman Respiratory Consultant
Lizan Drummond Respiratory Nurse Specialist
Louise Fitzpatrick Secretary to Dr Chapman
Julia Graves Respiratory Nurse Specialist
Julie Milburn Secretary to Dr Southern, Dr Ramsundar and Dr Joshi
Jillian Muwezwa Respiratory Nurse Specialist
Eunice Ogundimu Secretary to the Respiratory Nurse Specialists
Farida Parkar Respiratory CNS
Dr Parthipan Pillai Respiratory Consultant
Shadiqur Rahman Secretary to Dr Pillai, Dr Tariq, Dr Gnanapragasam and Mr Finch
Dr James Ramsay Respiratory Consultant
Dr Iain Southern MDT Lead - Respiratory
Dr Syed Tariq Respiratory Consultant
Claire Tipping Respiratory Nurse Specialist