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Respiratory and Sleep Physiology Service

Diagrammatic image of a pair of lungs and the trachea (windpipe). The lungs are shown in blue (exterior) and red (interior) and the trachea is shown in light grey
What the Respiratory and Sleep Physiology Service is and offers

The Respiratory and Sleep Physiology Service offers patients a range of diagnostic tests to investigate your breathing and how your lungs are working.

The tests that you may have in the department are the following – further information regarding these tests is provided below:

  • Spirometry
  • Reversibility
  • Full Lung Function Testing
  • Blood Gas Measurements
  • Overnight Oximetry
  • ApnoeaLink™

Currently, we are unable to offer Continuous Positive Airway Pressure (CPAP) therapy. This is provided by larger sleep services that are located in Health Boards or Trusts that are adjacent to Powys Teaching Health Board. If you need this then, in most cases, a referral will be made directly from our service to a CPAP service at one of these other Health Boards / Trusts.

We do not offer smoking cessation services, but the Help me Quit service takes direct referrals. If you are interested in giving up smoking, please click on the following link where you can self-refer to the Help Me Quit / Stop Smoking services in Wales. If you wish, we can make a referral for you to the Help me Quit service:

Help Me Quit | Stop Smoking Services In Wales.

Evidence shows that the single most important thing that you can do for health benefits, not just lung health, is to give up smoking.

 

Locations of the service

The central base for the Respiratory and Sleep Physiology Service is Bronllys Hospital. We are located in the Day Hospital unit on the site, behind Llewellyn Ward.

Outreach clinics providing Spirometry, Reversibility and Blood gas measurement testing are delivered in a number of locations throughout Powys. These clinics are held in:

  • Bronllys Community Hospital
  • Ystradgynlais Community Hospital
  • Llandrindod Wells Memorial Hospital
  • Glan Irfon Health and Care Centre, Builth Wells
  • Montgomeryshire County Infirmary (Newtown Hospital)
  • Bro Dyfi Hospital (Machynlleth Hospital)
  • Victoria Memorial Hospital (Welshpool Hospital)

Full Lung Function Testing can currently only be offered at Bronllys Community Hospital. The size and sensitivity of the equipment means that it is not mobile.

Overnight Oximetry and ApnoeaLink™ appointments are virtual, using the Attend Anywhere digital system. This enables patients to stay closer to home to get the test done. Further information on Attend Anywhere appointments and guidance on how to use this digital approach is available at the following link:

Virtual Clinics with Attend Anywhere - Powys Teaching Health Board (nhs.wales)

Sometimes patients are offered appointments in locations that are not necessarily their nearest hospital. This is because sometimes the waiting lists are longer in a particular location, and the test will be performed quicker at an alternative location. If you would prefer to wait and be seen closer to home, please just let us know when we contact you to book your appointment.

 

 

 
Referral methods

Patients can be referred to the service from a number of sources. This includes your GP (General Practitioner), consultants within Powys Teaching Health Board and other Health Boards, Respiratory Specialist Nurses, the Powys Living Well Service and specialists from other Health Boards. We do not offer a self-referral service, so patients are unable to refer themselves to the service.

 
Referral criteria advice for Healthcare Professionals

 

Referral criteria for Spirometry testing, Reversibility testing and Full Lung Function testing:

Before a patient is considered for referral to the Respiratory Physiology Service, please ensure that they are optimised. This includes:

  • Good compliance and technique with inhalers
  • Referral to virtual pulmonary rehabilitation if suffering from Chronic Obstructive Pulmonary Disease (COPD)
  • Referral to smoking cessation services where appropriate

Inclusion Criteria:

Patients that are suffering from a new onset of respiratory symptoms or have been advised by work Occupational Health services to seek advice. Such as:

  • Shortness of breath
  • Cough for more than six weeks
  • Sputum production
  • Reduced exercise tolerance
  • Suspected asthma
  • Recurrent respiratory tract infections

Exclusion Criteria:

Patients that:

  • Have an already established respiratory diagnosis
  • Are suffering a single episode of respiratory tract infection
  • Are currently being investigated through the Cardiology team for unidentified or unstable heart conditions
  • Have had spirometry testing done within the last 12 months
  • Have a requirement for FEV1 as part of an annual review

 

Referral criteria for Sleep Studies / Overnight Oximetry / ApnoeaLink™:

Before a patient is considered for referral to the Sleep Service, please ensure that baseline bloods are completed, including:

  • Full Blood Count (FBC)
  • Thyroid-Stimulating Hormone (TSH)
  • Thyroxine (T4)
  • Hormone levels (where appropriate) to exclude other causes for daytime sleepiness

Inclusion Criteria:

Patients that are suffering from:

Exclusion Criteria:

Patients:

  • Not suffering from signs or symptoms of obstructive sleep apnoea
  • With parasomnias
  • Suffering insomnia only

 

The following link provides the referral form required to refer a patient for an appointment with our service for Overnight Oximetry, to investigate possible obstructive sleep apnoea. Please complete this form, attach a medical summary and submit through the Welsh Clinical Communications Gateway (WCCG) system:

Referral proforma for Powys Sleep Service

 

Continuous Positive Airway Pressure (CPAP) therapy is not available:

Please note, Powys does not currently offer a CPAP treatment service and will forward the diagnostic report back to the referrer. Where onwards referral is required, this will be the responsibility of the Healthcare Professional making the original request.

 

Blood Gas Measurements:

Requests for blood gases can only be made by Respiratory and Neurology teams. These can be out-of-area teams.

 

What should patients expect during appointments

All appointments are booked in advance. You will be sent an information leaflet that details the test you are coming for, any pre-test instructions (such as withholding medication) and any contraindications (things that would stop you having the test). Please always ensure you have read the leaflet before you attend for your test and please get in touch with the service / referrer if you have any queries. A copy of each of the leaflets is also included below within the relevant named test sections.

During your appointment, either face-to-face or virtual, you will be seen by either a Respiratory Physiologist or a Health Care Support Worker. These staff will guide you through your appointment and ensure that the results obtained during your test are suitable and accurate, to ensure you get the best possible diagnosis, care and treatment for you.

Further information is included below describing the various diagnostic tests provided by the service to investigate your breathing and how your lungs are working. Click the following sections to expand them and read further detail:

 

Advice and support resources

 

Asthma + Lung UK (formerly the British Lung Foundation (BLF)) have a wealth of information on all things respiratory, including tests, respiratory disease and what patients should expect from their Healthcare Professionals. Please see their website at the following link:

Asthma + Lung UK (asthmaandlung.org.uk)

 

Asthma + Lung UK have also released a report called 'Diagnosing The Problem: Right Test, Right Time'. This is a report into the provision of key respiratory diagnostic tests, investigating ways to improve early and accurate diagnosis. The report is available via the following link to the relevant Asthma + Lung UK webpage:

Diagnosing the problem: Right test, right time | Asthma + Lung UK (asthmaandlung.org.uk) 

 

The Sleep Apnoea Trust has detailed information for all patients that are being investigated or treated for obstructive sleep apnoea. Please see their website at the following link:

Sleep Apnoea Trust - A patient support charity (sleep-apnoea-trust.org)

 

If you are a patient in Wales, suffering asthma or Chronic Obstructive Pulmonary Disease (COPD), there are NHS Wales digital apps that can support your management. For further detail please see the following NHS Wales link:

NHS Wales Patient Respiratory Self-Management Apps - Primary Care One

 

If you are currently waiting for surgery or treatment, preparing effectively and learning how to manage your symptoms can make a significant difference to your treatment outcome and recovery. Powys Teaching Health Board’s ‘Keeping Well While You Wait’ webpage provides a range of advice to support this, at the following link:

Keeping Well While You Wait - Powys Teaching Health Board (nhs.wales)

 

 
 
Contact details for the service

The telephone number for the department is:

  • 01874 712457  - Please use this number to schedule, change or cancel an appointment

The phone has an answerphone so please do not hesitate to leave a message. A member of the team will get back to you as soon as possible.

 

Meet the team

 

Kimberley Lewis: Head of Department

 

Kimberley is the head of the Respiratory and Sleep Physiology department. She has been a fully qualified Physiologist since 2008. Kimberley is dedicated to passionate care and accurate diagnosis for all.

 

Kym Swan: Administration Support Officer

Kym has worked for the NHS in Administration Support since 2008, initially in London and since 2016 for Powys. She has over 35 years’ experience in this field and is always happy to help!

 

Rhodri Curtis: Respiratory Physiologist

Rhodri graduated from Swansea University in 2023 with a degree in Respiratory and Sleep Physiology (BSc).  Rhodri is highly passionate about Respiratory Health and is dedicated to supporting you within our service from a care and knowledge perspective.

 

Lydia McGettigan: Health Care Support Worker

Lydia has worked for the NHS for approximately 18 years in varied roles, specialising in the last two years within the Community Respiratory Team based in North East Powys. Lydia is currently developing her role within the Physiology Department by undertaking Spirometry clinics guided by the Physiologist.

 

Michelle Watson: Health Care Support Worker

Having started life in Canada and moved to the UK in 1993, Michelle is a Sheffield Hallam alumna and has worked in the NHS for over 15 years. She is proud to have been involved in the Powys Vaccination Programme as a Covid-19 Immuniser. Michelle is enjoying specialising in respiratory support and looking forward to increasing her skills in spirometry and using this to help our respiratory patients.

 

Sian Hayward: Health Care Support Worker

Sian started working in the NHS in 2002 and has been fortunate to have worked in a wide variety of clinical roles. Sian recently joined PTHB from the District Nursing Team in Cardiff and Vale University Health Board, as she along with her family plan to relocate to South Powys. Sian is looking forward to gaining new skills and knowledge and to be able to help and support our respiratory patients.

 

Patient feedback

We welcome your feedback at any time regarding your experience as a patient of the Respiratory and Sleep Physiology Service. Please feel free to provide feedback via the following website link, or via scanning the ‘QR code’ image below using your smartphone / device, which will take you to the same website location:

Patient Feedback – Powys Teaching Health Board Respiratory and Sleep Physiology Service

 

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