Respiratory (lung care)

  • Providing support to patients with chest and lung conditions

  • Address: Maidstone Hospital and Tunbridge Wells Hospital,

What we do

Respiratory services treat and care for patients with conditions such as lung cancer, sarcoidosis, chronic obstructive pulmonary disease (COPD), asthma, interstitial lung disease (ILD), bronchiectasis and tuberculosis (TB).

The respiratory team includes respiratory consultants, respiratory nurses, healthcare scientists (physiologists), physiotherapists and administration staff.

There are dedicated respiratory wards at Maidstone and Tunbridge Wells hospitals: Ward 21 at Tunbridge Wells Hospital and John Day Ward atMaidstone Hospital.

We offer specialist and general outpatient services, including for lung cancer, bronchiectasis, TB, pulmonary fibrosis, pleural diseases, asthma and a COPD HOT clinic.

Our integrated COPD pathway works across primary and secondary care. We have an established home oxygen service and pulmonary rehabilitation service.

Get in touch

Maidstone Hospital – 01622 225256

  • Sandra Wakelin, Lung Clinical Nurse Specialist
  • Fran Bevans, Lung Clinical Nurse Specialist
  • Michelle Bird, Macmillan Cancer Support Worker

Tunbridge Wells Hospital - 01892 635358

  • Louise Gilham, Lung Clinical Nurse Specialist
  • Alison Smith, Lung Clinical Nurse Specialist
  • Florina Hewitt, Lung Clinical Nurse Specialist
  • Michelle Bird, Macmillan Cancer Support Worker

Chest physicians/respiratory consultants

  • Dr S Webster (Secretary) 01892 635580 / 01892 635525
  • Dr T Loke (Secretary)  01892 635580 / 01892 635525
  • Dr A Satgunarajah (Secretary) 01892 635580 / 01892 635525
  • Dr R Mankragod (Secretary) 01622 224299 / 01622 225589
  • Dr S Husain (Secretary) 01622 224299 / 01622 225589

Oncologists

  • Dr Shah (Secretary) 01622 226049, chemotherapy, immunotherapy, targeted.
  • Dr Sevitt (Secretary) 01622 225041: radiotherapy, SABR, chemotherapy, immunotherapy, and targeted.

Surgeon

  • Mrs Karen Harrison-Phipps – Guy’s Hospital 0207 1887943

Macmillan lung care clinical nurse specialists

  • Sandra Wakelin/Fran Bevans – Maidstone 01622 225256
  • Louise Gilham/Alison Smith – Tunbridge Wells 01892 635358
  • Florina Hewitt - Tunbridge Wells 01892 635358

Macmillan cancer support worker

  • Michelle Bird – 01892 635358 or 01622 225256

Tests and investigations

  • CT and CT-guided biopsy
    • Maidstone 01622 225688
    • Tunbridge Wells 01892 634729
  • Ultrasound CT/biopsy
    • Maidstone 01622 224027
    • Tunbridge Wells 01892 633406
  • Lung function tests
    • Maidstone 01622 224521
    • Tunbridge Wells 01892 634684
  • Bone scan
    • Maidstone 01622 225047
    • Tunbridge Wells 01892 634733
  • PET scan (Alliance Medical) 
    • Maidstone 081622 228235
  • Bronchoscopy/EBUS: 01892 638210

Our team

Consultants

There are currently respiratory consultants at Maidstone and Tunbridge Wells hospitals.  The respiratory services are mirrored across the two hospitals, but interventional bronchoscopy is only done at Maidstone Hospital.

Clinical nurse specialists

The clinical nurse specialist team are based at Maidstone and Tunbridge Wells hospitals and support patients who have:

  • Chronic obstructive pulmonary disease (COPD)
  • Acute asthma
  • Interstitial lung disease
  • Tuberculosis (TB)
  • Complex oxygen requirements

Patients are supported with education and given advice on how to better manage their condition. Outpatient clinics are run for patients with asthma, TB and those who require oxygen at home.

The nurses are part of a multi-disciplinary team who deliver an integrated care pathway for COPD patients. This pathway allows COPD patients whose condition is worsening to have support both in hospital and at home by a dedicated specialist team. Patients are encouraged to attend pulmonary rehabilitation classes and given support to better manage their condition at home

Lung Care team

The Lung Care team support patients who have been referred to a chest physician via their GP or healthcare professional due to an abnormality on their scan or x-ray.

The team work closely with the chest/respiratory consultant physicians, Kent Oncology Centre, multi-disciplinary team co-ordinator and secretaries.

Your appointment

You may have been referred to see a chest physician via your GP or healthcare professional because of an abnormality on your scan or X-ray.

New patient appointments usually take about 20 minutes and you will be seen by a respiratory/chest doctor and possibly a clinical nurse specialist.

Clinics are in the main outpatients department at Maidstone Hospital and in outpatients zone 1 at Tunbridge Wells Hospital.

What happens next?

We may request a range of investigations or ongoing monitoring. The tests usually take 2-4 weeks to complete and the results will enable the team to make a diagnosis and to start you on the best treatment or management plan. Further details about the tests can be found below.

You may be asked to have the following investigations:

Blood test

Bone scan: This test shows abnormal areas of bone using a small amount of mildly radioactive substance injected into a vein.

Bronchial challenge test

Bronchoscopy: A test where a doctor looks at the inside of the airways and lungs using a tube called a bronchoscope. See the endoscopy service for more information.

Chest X-ray

CT (computerised tomography) scan: A series of X-rays, which build up a three-dimensional picture of the inside of the body. 

Echo-cardiogram (ECG): A scan used to look at the heart and nearby blood vessels using type of ultrasound scan which gives information about the function and effectiveness of the heart.

EBUS (endobronchial ultrasound scan): A bronchoscope (which has a small ultrasound probe on the end) is passed into your windpipe, and a needle is passed along the bronchoscope to take biopsies from the lung or nearby lymph nodes. See the endoscopy service for more information.

Hypoxic challenge (or 'fit to fly' test)

Lung function tests: Also called pulmonary function tests (or PFTs) these check how well your lungs work.

Lung biopsy – CT guided/ultrasound guided: This test can be done by CT or ultrasound. A thin needle is passed through the skin and into the lung and a sample of cells (biopsy) is taken.

Mediastinoscopy: This test uses a small cut in the skin at the base of your neck and passes a tube into your chest to take samples of tissue and lymph nodes (biopsies).

PET (positron emission tomography) scan: This test uses low dose radiation to measure the activity of cells in different parts of the body. A mildly radioactive substance is injected into a vein, usually in your arm.

Pleural aspiration/biopsy: A simple procedure to remove fluid from the chest using an ultrasound scan to insert a needle into the chest and take fluid or a biopsy.

Reversibility test: A test to find out if your lung function can be improved after you have been given an inhaler.

Skin prick test: a quick procedure used to identify allergic reactions to common airborne substances like pollen, dust mites, and mould.

Six-minute walk test: This test helps measure how well your lungs are supplying oxygen to the rest of your body during exercise.

 

What happens next?

Following these investigations your case will be discussed at the multi-disciplinary meeting where clinical nurse specialists, the respiratory/chest consultant physicians, thoracic surgeon, radiologists, histopathologist and oncologists meet to discuss your results and management plan.

You may be called at short notice following this meeting to meet the consultant or clinical nurse specialist to discuss your results and management plan.

Respiratory physiotherapy

Based across Maidstone and Tunbridge Wells hospitals, Respiratory Physiotherapy provides a comprehensive service to inpatient wards and outpatient services.

Both teams cover a large number of wards, including the intensive care unit (ICU), high dependency unit (HDU), coronary care (CCU), respiratory, surgical, and medical wards. Patients with a variety of respiratory conditions will be assessed, treated, and rehabilitated.

We assist with secretion clearance, improving lung volumes, assisting with weaning from ventilation, providing secretion management strategies, breathlessness management strategies and using techniques to increase exercise tolerance.

We aim for a time-efficient and safe discharge, and our input starts when a patient is critically unwell, and follows them through to being medically stable and then discharged home.

We want to help patients effectively regain their function and return to baseline abilities, and support them as they move to community hospitals, a COPD pathway, pulmonary rehabilitation and outpatient follow up appointments.

Pulmonary rehabilitation service 

The Pulmonary Rehabilitation service is based in community venues across west Kent, courses run for six weeks with patients attending classes twice a week. Patients take part in an exercise programme and receive education about their condition and how to manage their symptoms. Patients can be referred to this service via their consultant, GP, respiratory nurse or physiotherapist.

Bronchiectasis clinics

Bronchiectasis clinics are offered as an outpatient service at both hospitals. This service is for patients who are under the care of an MTW respiratory consultant, and we help them complete the most appropriate and effective daily method of airway clearance and exacerbation management. 

Patients with other respiratory conditions may also be offered clinic appointments.

Respiratory physiology

Respiratory Physiology offers diagnostic tests to help diagnose, treat and monitor respiratory and sleep conditions.

A dedicated team of respiratory physiologists support the work of the consultants, including referrals from many specialities, and perform tests for inpatients and outpatients aged 16 and above. 

We also support student physiologists during their training by providing work placements. A student may perform tests with patients as part of their training, but they will always be supported by a senior member of staff.

Location

  • Tunbridge Wells Hospital: Room 20, Outpatients, zone 1.
  • Maidstone Hospital: Lung Function Room, Acute Stroke Unit (ASU), ground floor, purple zone.
  • West Kent Community Diagnostic Centre (CDC), Hermitage Court, Hermitage Lane, Maidstone.

Opening times

The department is open Monday to Friday, 8am to 4pm, at Maidstone and Tunbridge Wells hospitals, and seven days a week at the West Kent Community Diagnostic Centre. Some tests are only bookable on set days.

For more information on these tests, see "your appointment"

Basic tests

Lung function test (LFT) / pulmonary function test (PFT)

  • Dynamic lung volumes (spirometry)
  • Gas transfer (single breath TLco)
  • Static lung volumes (body plethysmography)
  • Trials before and after inhalers (reversibility test)
  • Ward spirometry for inpatients

Pulse oximetry

Field exercise tests

Six-minute-walk test

Special tests

  • Respiratory muscle strength testing (sitting, supine, maximal inspiratory and expiratory pressures, and sniff nasal inspiratory pressures)
  • Bronchial challenge test (mannitol)
  • Hypoxic challenge test (Fit to Fly)
  • Skin prick tests to common allergens
  • Fractional exhaled nitric oxide testing (FENO)
  • Overnight oximetry
  • Blood gas measurement (capillary)

Sleep tests

Sleep studies/overnight oximetry

Outpatient diagnostic sleep studies for suspected obstructive sleep apnoea (OSA) can be referred by GPs in Kent can refer via ERS and REGO

Outpatient diagnostic devices include Watchpat® 300 and SOMNOtouch™ Resp

Treatment

Continuous positive airway pressure (CPAP) for obstructive sleep apnoea (OSA)

  • Outpatient OSA treatment service for patients registered with a west Kent GP. 

Non-invasive ventilation (NIV) for obesity hypoventilation syndrome (OHS)

CPAP or NIV patients having problems with the treatment or device

Email mtw-tr.lungfunctionandsleep@nhs.net  or call Monday to Friday, 8.30am to 3.30pm, on 01622 224521 or 01892 634684.

Please leave a voicemail and you will be called back.