In this section
Welcome to the General Respiratory service
We help people in South Manchester and Trafford who have problems with their breathing.
We see patients in clinics at Wythenshawe Hospital, Trafford General Hospital, Altrincham Hospital and Withington Hospital. At Wythenshawe Hospital, clinics are in the Chest Clinic area, the Main Outpatients area, and the Respiratory Day Unit near the Neil Cliffe Centre.
In the clinic, we try to find out the cause of breathing problems, like feeling short of breath, coughing, bringing up phlegm (mucus), or sharp chest pain when you breathe in or cough. When we know what the problem is, we will talk to you about the best treatment. We also see people who already have lung problems to check how they are doing and make sure their treatment is still right for them.
Most people do not need lots of follow-up appointments in this clinic. When their treatment is working well, we may send them back to their GP to look after them with a clear plan. If someone needs extra help, we can refer them to a more specialist chest clinic.
We also have a Respiratory SDEC (Same Day Emergency Care) service. This is for people who need to be seen quickly, but do not need to stay in hospital overnight.
At Wythenshawe Hospital, there are two chest wards (A1 and F4). This is where patients stay if they need care in hospital.
Conditions we treat
COPD & emphysema
Chronic obstructive pulmonary disease is usually called COPD. It is a long-term lung condition. In COPD, the breathing tubes in the lungs become swollen, damaged and narrow. This means air cannot move in and out of the lungs as easily, so people may feel short of breath.
COPD is a name used for a group of lung problems. These include long-term (chronic) bronchitis and emphysema. Many people with COPD have both.
COPD is common. About 1.7 million people in the UK are thought to have COPD. Some people have COPD but do not know it yet.
COPD often comes on slowly over many years. It can get worse over time. COPD cannot be cured at the moment, but treatment can help with symptoms and make breathing easier.
What does COPD mean?
- Chronic means it lasts a long time.
- Obstructive means the breathing tubes are narrowed or blocked, so it is harder to breathe out.
- Pulmonary means it is about the lungs.
- Disease means it is a medical condition.
You may be referred to the general respiratory clinic to have tests to check if you have COPD. These can include lung function (breathing) tests and sometimes a CT scan.
You may also be referred to the general respiratory clinic if you already have COPD so that we can check your treatment and make sure it is working as well as possible. You may be referred for pulmonary rehabilitation in the community.
You may be referred on to a more specialised service here if it is felt you would benefit from extra specialist treatments.
Asthma
Asthma is a lung condition. It affects the breathing tubes that carry air in and out of the lungs. These tubes can become swollen and narrow, which can make it harder to breathe.
Asthma is very common. In the UK, about 7.2 million people have asthma. This means around 8 out of every 100 people have it.
Asthma symptoms can include wheezing (whistling when beathing), feeling short of breath, coughing, or a tight feeling in the chest. Sometimes these symptoms can get worse suddenly. This is called an asthma attack.
Asthma symptoms can be set off by things such as exercise, allergies, or changes in the weather. These are called triggers. Different people may have different triggers.
There is no cure for asthma at the moment. However, most people can manage their asthma well with inhalers and other medicines. Some people may go for weeks or months without symptoms.
You may be referred to the general respiratory clinic to have tests to check if you have asthma. These can include lung function (breathing) tests and blood tests.
You may also be referred to the general respiratory clinic if you already have asthma so that we can check your treatment and make sure it is working as well as possible.
You may be referred on to a more specialised service here if you have significant problems with your asthma despite treatment.
Long-standing cough
Most coughs happen after a cold or flu. They usually get better within 4 weeks.
Some coughs last longer. A cough that lasts more than 8 weeks is called a chronic cough. Common causes include:
- smoking
- acid coming up from the stomach, also called reflux or heartburn
- allergies, such as hay fever
- asthma
- chest infections
- mucus running from the nose into the throat
- a throat that is easily irritated
- some medicines
You may be referred to the general respiratory clinic if you have a chronic cough to look into the cause of the cough. This may involve having tests done, including blood tests, lung function (breathing) tests and a CT scan. We can also give advice on the best treatments for your chronic cough to make sure it is working as well as possible.
You may be referred on to a more specialised service here if you have significant problems with cough despite treatment.
Bronchiectasis
Bronchiectasis is a long-term condition where the airways in your lungs can produce more phlegm than usual, and the little hairs in your airways don’t work quite as well to keep your lungs clear of phlegm. The airways can become wider than usual and phlegm (also called sputum or mucous) can build up in them. This can increase the chance of you getting chest infections, as the built-up phlegm makes it easier for bacteria to get trapped in your airways.
Bronchiectasis is sometimes called non-cystic fibrosis (non-CF) bronchiectasis. This is because bronchiectasis and cystic fibrosis share some symptoms. However, the treatment and outlook are different for each condition.
You may be referred to the general respiratory clinic to have tests to check if you have bronchiectasis. These can include a CT scan of your lungs, and you may also need lung function (breathing) tests and blood tests.
You may also be referred to the general respiratory clinic if you already have bronchiectasis but are getting problems with managing the phlegm you are producing or if you are getting lots of chest infections so that we can check your treatment and make sure it is working as well as possible.
You may be referred on to a more specialised service here if you have significant problems with frequent infections because of your bronchiectasis.
Repeated chest infections
A chest infection is an infection in the lungs or the larger breathing tubes. Many chest infections are mild and get better by themselves. Some can be more serious. If you keep getting chest infections, we may see you in clinic to look for a cause and talk about what may help.
Pneumonia
Pneumonia is an infection in the lungs. It can make the lungs inflamed, and you might become breathless, have high temperatures and produce sputum (also called phlegm or mucous).
The lungs have tiny air spaces that help you breathe. When you have pneumonia, these air spaces can fill with fluid. This can make it harder to breathe.
Pneumonia is a type of chest infection. It is usually seen on a chest X-ray or CT scan.
A chest infection is a general name for an infection in the lungs or breathing tubes.
Many people start to feel better within 2 to 6 weeks, but it can take longer to fully recover. Babies, older people, and people with heart or lung problems may become more unwell and may need treatment in hospital.
You may be seen in a general respiratory clinic if you have been in hospital with pneumonia to check that it has got better, and to assess if any other tests are needed.
You may also be seen in the general respiratory clinic if you keep getting pneumonia or chest infections. We will try to find out why this is happening and talk to you about ways to reduce how often you get chest infections and how serious they are. You may need more chest X-rays, blood tests or a CT scan.
Interstitial lung disease
Interstitial lung disease (ILD) is a lung condition that includes varying degrees of inflammation and scarring in the lungs. There are many types of interstitial lung disease, and the treatments and the outlook is different for each type.
Some forms of ILD get worse over time, although in some cases, medications can be used to slow this process down. For other types of ILD, some treatments are available which can improve the condition. Sometimes, certain lifestyle changes can help.
The most common type of ILD is Idiopathic Pulmonary Fibrosis (IPF). Idiopathic means there is no known cause. Pulmonary means it affects your lungs. Fibrosis is another name for scar tissue.
You may be seen in a general respiratory clinic if there is a suspicion that you may have ILD, and to try to determine the type of ILD you have. You may be referred on to a more specialised ILD clinic if you are found to have ILD.
Breathing pattern disorders
A breathing pattern disorder means your breathing has changed and is not working as well as it could. You may breathe too quickly, too slowly, take bigger breaths than you need, breathe through your mouth, breathe high in your chest, or have an uneven breathing pattern.
It is normal for breathing to change at times, such as when you are active, stressed or unwell. Sometimes these changes carry on and become a habit. This can cause symptoms like breathlessness, the sensation you can’t get enough oxygen into your lungs (even if you can), tingling in the lips and fingers and dizziness. Having a breathing pattern disorder can make it harder for your breathing to settle back to normal, and while it is not dangerous, it can feel unpleasant.
You may be diagnosed with a breathing pattern disorder in a general respiratory clinic after other causes of breathlessness have been ruled out, and if your symptoms are in-keeping with this condition. If you are found to have a breathing pattern disorder, this can be treated by our respiratory physiotherapy team. In the meantime, please find a link below which gives some helpful advice about the condition.
Outpatient clinics
You may receive an appointment to be seen in a general respiratory outpatient clinic if you have been referred by your GP, a hospital doctor from a different specialty, or if you have recently been admitted under respiratory medicine and the consultant in charge of your care thinks you need to be seen in a clinic after discharge.
Once you have been referred to general respiratory outpatients, a consultant will assess the information that has been sent, and may choose to request relevant tests to be organised before you come to clinic. You will be sent a letter with details about these tests, and the results will be discussed with you when you are seen in the clinic.
A consultant is in charge in every outpatient clinic. The consultant leads a team of resident doctors, advanced care practitioners and physician associates.
Any of these team members could see you in the clinic, and all of them are appropriately trained to do so. They always have the option of discussing your case with the consultant in charge. If you would prefer to see the consultant, you can ask the nurse in charge of the clinic, but this may mean you have to wait longer in the clinic waiting room. Rarely, this may not be accommodated if the consultant is not available, and your appointment could be re-scheduled to a later date.
As we are a large teaching hospital, it is possible that resident doctors, medical students, nursing students and physician associate students may be present in clinic. It is really important that students are given the opportunity to learn, as they will be the NHS staff of the future, and we are very grateful if you allow them to be in the clinic room when you have your appointment. However, you do not have to have students present, so please let the doctor or nurse know if you would prefer it if they are not there.
At your first clinic appointment, we will ask about your health and symptoms. We may also ask about things that can affect your lungs, such as smoking, your work, and any lung problems in your family. You may need an examination, but this is not always needed. The clinician who sees you may arrange tests or suggest treatment. Some tests, such as blood tests, a chest X-ray or an ECG heart tracing, may be done on the same day. Other tests, such as breathing tests, CT scans or heart scans, may need a separate appointment.
After your appointment, we will write to the doctor who referred you and to your GP. We may also send a copy of the letter to you.
You may be offered another appointment if this is needed. However, many people only need to come to the general respiratory clinic while we find out what is wrong and make sure their treatment is right. After this, your GP may continue your care. If you need longer-term follow-up, we may refer you to one of our specialist respiratory services.
Respiratory same day emergency care (SDEC) unit
If you need to be seen by a respiratory medicine doctor more urgently, but it is not felt that you need to be admitted to hospital, you may be referred to the Respiratory SDEC unit by your GP or by one of the Emergency Department doctors.
The SDEC unit is located around the corner from the ED department in Wythenshawe Hospital.
The SDEC unit is run by senior resident doctors who specialise in respiratory medicine (Respiratory registrars).
In a similar way to attending an outpatient appointment, the doctor will ask about your health and symptoms. They may also ask about things that can affect your lungs, such as smoking, your work, and any lung problems in your family. You may need an examination, but this is not always needed. The clinician who sees you may arrange tests or suggest treatment. Some tests, such as blood tests, an ECG heart tracing, a chest X-ray or CT scan may be done on the same day. Other tests, such as breathing tests, some CT scans or heart scans, may need a separate appointment which the doctor will arrange. You may be asked to come back to the SDEC unit the following day to have some of these tests done. Alternatively, you may be referred to an outpatient clinic.
The doctor will aim to give you a diagnosis about what may be causing your symptoms, and will recommend appropriate treatment. If no concerning conditions are found, they will offer you reassurance.
Inpatient Wards
The general respiratory inpatient wards are Ward A1 and Ward F4 at Wythenshawe hospital. If you have a respiratory condition which can only be treated in hospital, then you may be admitted to one of these wards. You may need to be admitted to hospital if:
- You need to breathe extra oxygen through a mask or nasal tube to keep your body’s oxygen levels satisfactory while you recover from a respiratory illness.
- You need medications that can only be administered into your vein by a drip, such as some antibiotics, or extra fluids.
- You have asthma and need nebuliser treatment which you don’t usually have at home.
- Your respiratory illness has temporarily made you too weak to safely manage at home.
- You need to have monitoring of your pulse, blood pressure, oxygen level or blood tests to make sure you are getting better.
- You have a chest drain to manage extra air or fluid around the lungs.
- Treatment with a non-invasive ventilator machine.
Conditions which are commonly treated on a respiratory ward include flare-ups of COPD, asthma, bronchiectasis or ILD; pneumonia; pulmonary embolus (blood clot on the lungs); respiratory failure among others.
What tests might I have?
- Chest X-rays
- Sputum culture tests
- Urine tests
- ECG hearts tracings
- CT scans of the lung
- Lung function breathing tests
- Echocardiogram heart scans