This is a specialist clinic for people who have been given a label of asthma, but continue to have difficult symptoms despite being on regular medication. These symptoms could be breathlessness, cough and / or wheeze.
During the clinic, you may see different specialists and have different assessments in one visit. This should reduce the number of hospital appointments that you need.
It means our team can work together to find the best treatment options for you.
At the end of the clinic, a respiratory doctor will talk to you about their findings and treatment options. You can work together to plan your next treatment steps.
If you have been referred from a different health centre, all findings and treatment plans will be fed back to your local respiratory team and GP.
You will see experts who specialise in asthma. The lead consultants for this clinic are Dr Sean Parker and Dr Nicola Green.
In this clinic, you may see:
- Respiratory doctor: To review your medications, assessment findings, and talk about different treatment options.
- Respiratory nurse: To review your inhaler technique and talk about any medication issues. To explore ways to support your asthma control.
- Speech and language therapist (SLT): To look at any throat (laryngeal) disorders that may be causing cough and breathlessness.
- Physiotherapist: To look at your breathing muscles, and how fast you are breathing.
- Pharmacist: To review your medication and advise on possible alternatives.
- Respiratory physiologists: For lung function tests to check how well your lungs are working.
People are usually referred from specialist respiratory doctors. Some people are referred by their GP, asthma nurses, physiotherapists or speech and language therapists.
We accept referrals from out of area, including for a second opinion.
You will get an appointment letter in the post. Sometimes if there is a last-minute cancellation, we will phone you to see if you could come at late notice.
The asthma clinic appointment usually lasts 2-3 hours. This will include all assessments, talking to different specialists about your findings, and talking to the respiratory doctor at the end to make a treatment plan.
Please bring inhalers to your appointment.
We ask questions to better understand your symptoms, what could be making them worse, and what could be done to reduce them.
Key questions are:
- What are your main symptoms?
- Have you noticed any patterns? This could be what makes symptoms better or worse, any triggers, and if symptoms are better or worse at certain times.
- What medications have you tried? How helpful (or unhelpful) did you find them?
- How easy do you find it to take your medications regularly? Do you use a spacer with inhalers?
- History of chest infections, including use of antibiotics and/or steroids, especially over the last year
- History of hospital admissions, especially over the last year
- History of smoking, including e-cigarettes and vaping
- Do you have reflux or sinus problems? How are these managed?
You may be asked to fill out questionnaires to give us a better idea of your symptoms and the impact they have on your daily life and wellbeing.
Assessments may also include:
- Spirometry: To measure how much air you can breathe out in one breath
- Flow Volume Loop: To check airflow obstruction
- FeNO (Fractional Exhaled Nitric Oxide) test: To look at the level of inflammation in your airways
- Blood tests: To check your immune system and / or signs of infection
- A nasendoscopy assessment: To check how healthy your throat is, and to see whether the muscles in your throat are causing cough and / or breathlessness
- Breathing Pattern Disorder (BPD) assessment: To test how your breathing muscles are working, including how coordinated they are, and how much effort is being used to breathe
- Checking your inhaler technique and peak flow technique: To make sure you understand how to use these correctly
This will depend on the outcome of your assessments. We will arrange this together with you, and your local team (or the person that referred you).
Treatment usually includes:
- Medication review, and possibly changing your medication regime
- Potentially trialling new medications
- Throat care advice
- Breathing exercises
- Lifestyle advice
Follow-up may take place to check on your progress. This can be face-to-face or or by phone. It is also possible to refer you back to your local team for follow-up.
It is not always possible to completely resolve asthma symptoms.
However, evidence suggests that treatment tailored for you can help to:
- Reduce how severe your symptoms are
- Reduce how often you get symptoms
- Improve control of symptoms
Overall improvement will depend on different factors. This includes how easy it is for you to:
- Make recommended lifestyle changes
- Take recommended medications, at recommended times
- Practice breathing exercises regularly
- Manage ‘other’ factors that may be contributing to symptoms e.g acid reflux, sinus problems, medication use (e.g. ACE inhibitors)
Right Breathe inhaler usage: https:/
All about asthma: https://
How to use your inhalers: https://
Eating well for healthier lungs: https://
Breathlessness: https://
Adult asthma action plan: https://
Peak flow diary: https://
My asthma inhalers: https://
What to do in an asthma attack: https://
Asthma attack recovery plan: https://
Asthma plan in Arabic: https://
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