The wide variety of respiratory conditions (see Respiratory disease areas below) and symptoms mean there are many ways for patients to access care. Referrals from primary to secondary care can be to:

  • general respiratory clinics
  • rapid access clinics (eg fast-track cancer services, TB services)
  • specialist secondary care respiratory clinics (eg asthma, cough, COPD, interstitial lung diseases, sleep disordered breathing)
  • regional specialist services (occupational medicine, cystic fibrosis, pulmonary hypertension, interstitial lung diseases, difficult asthma, home ventilation).

Respiratory physicians are increasingly holding combined clinics in secondary care with colleagues from other specialties (eg allergy, cardiology, ENT surgery, neurology, oncology, palliative care, rheumatology).

Growing numbers of respiratory physicians are working with colleagues in primary care to deliver integrated networks of care, improve skills and support primary care practitioners. This in turn improves care quality, reducing hospital admissions and referrals to secondary care. The British Thoracic Society initiative, Respiratory Futures, provides a unique platform focused on the goal of providing high-quality respiratory care, with a particular emphasis on integrated care teams.

Access from other hospital specialties can occur either via formal inpatient referral, in-reach services (eg COPD, lung cancer) or referral to the clinics described above.

Some services in respiratory medicine are delivered on a regional, supra-regional or national basis in England, for example: