Tertiary Referrals

  • Unexplained respiratory symptoms e.g. noisy breathing, cough,
  • breathlessness, chest pain, exercise intolerance.
  • Difficult to treat asthma / severe asthma
  • Severe infant wheezing
  • Cystic fibrosis
  • Recurrent pneumonia
  • Empyema
  • Obstructive sleep apnoea and other sleep disturbances
  • Tuberculosis (TB)
  • Congenital thoracic malformations
  • Ventilator-dependent children

Secondary Referrals

  • Unexplained respiratory symptoms e.g. noisy breathing, cough,
  • breathlessness, chest pain, exercise intolerance
  • Infant wheezing, Asthma, Chronic cough
  • Recurrent chest infections

Diagnostic Services

Simple tests that can be carried out in clinics–


  • Chest x-ray
  • Lung function (children aged 6 and over)
  • Allergy tests

Other Complex Investigations

More complex investigations are carried out at Royal Manchester Children’s Hospital and may involve an overnight stay.

  • Chest CT scan
  • Lung function testing including exercise tests, bronchodilator responsiveness
  • Sweat test (for Cystic Fibrosis)
  • Flexible bronchoscopy including airway brushings, bronchoalveolar lavage.
  • Sleep studies – level 1 (oximetry), level 2 (polysomnography - includes respiratory movement, nasal airflow, and video)
  • Nasal ciliary brushings and nasal nitric oxide (for primary ciliary dyskinesia)
  • Blood testing for allergy and immune function, CF genotyping.