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Referral Acceptance

Respiratory referrals are prioritised by Senior Medical Officers based on the information contained within. Additional information should be attached where available. The priorisation tool used to triage referrals can be found under Access Criteria.

All accepted referrals will be seen within a maximum waiting time of 4 months, unless there is a clinical reason for delay.

Referral acceptance is a follows:

First Specialist Assessments

Waiting priority 1


Waiting priority 2


Waiting priority 3


Waiting priority 4


Access Criteria


Criteria Examples Notes

Priority 1 Urgent  - HSCCan




Book within 14 Days


Suspected Neoplastic disease with OR WITHOUT significant symptoms.



Urgent non-neoplastic

  • Suspected lung/pleural cancer.
  • Recent significant haemoptysis.
  • SVC obstruction.
  • Symptomatic/progressive pleural effusion



  • Possible active pulmonary TB.
  • Suspected infective pleural disease/lung abscess

FSA within 2 weeks as per MoH (HSC referrals)


Ensure CT/PFTs requested



Consider acute admission/day stay/APU if indicated

Priority 2 Non HSCan


Book within 2 – 8 weeks

Other serious or rapidly progressive respiratory pathology.

  • Pulmonary/systemic vasculitis.
  • Primary pulmonary hypertension.
  • Acute or rapidly progressive ILD
  • Respiratory failure
  • Management of recurrent pneumothoraces
  • Request for home oxygen
  • Time frame 2-8 weeks unless otherwise indicated
  • Ensure appropriate tests organised at time of grading
  • Nurse led clinic for oxygen assessment

Priority 3 Non-urgent


Book within 4 months

Disabling, unstable or progressive disease not requiring admission but needing specialist assessment.



Major/moderate function impairment with moderate clinical risk requiring assessment and review.

  • Severe COPD with complications/potential transplant candidate.
  • Difficult to control asthma.
  • New diagnosis of interstitial lung disease.
  • Known Bronchiectasis with recurrent admissions
  • Active sarcoidosis
  • Pulmonary hypertension
  • Paediatric – adult transfer
  • Chronic cough with other issues eg purulent sputum, abnormal CXR, suspected important underlying disease.
  • Major diagnostic dilemmas.

-Dyspnoea of uncertain cause.

-Major/moderate respiratory disease with/complicating extra-pulmonary disease.

  • Time frame 8-16 weeks
  • Ensure appropriate tests organised at time of grading
  • Consider whether Respiratory Nurse clinic may be appropriate
  • Consider whether virtual advice may be more appropriate or advice beneficial whilst awaiting FSA
  • Aim to formally transfer paediatric patients and have dual physician attendance at Paediatric clinic prior to transfer

Priority 4

(Not accepted)


Past history suggests mild-moderate functional impairment where specialist advice is likely to be sufficient

  • Mild to moderate COPD.
  • Pleural plaques.
  • Stable radiologic abnormalities.
  • Low risk Pulmonary nodules
  • Chronic cough without important other issues.
  • Virtual advice
  • Nodule clinic