Respiratory medicine specialties

Coronavirus: respiratory medicine update

In response to the coronavirus (COVID-19) outbreak, please read our advice and information before attending the service.

Specialist services

• Asthma clinic

  Guy’s and St Thomas’ NHS Trust is one of the leading asthma centres in the UK reviewing around 200 asthmatic patients per week. We are responsible for the care of all severe asthmatics in central and south east London as well as across Kent and East Sussex. Our team of doctors and other healthcare professionals (multidisciplinary team) ensure our patients receive the very highest level of acute and chronic care.

  Subspecialist asthma clinics at Guy’s and St Thomas’ include:

  • exacerbation ‘hot clinic’ for patients experiencing a recent asthma attack
  • severe asthma clinic for patients on biologic therapies including benralizumab, mepolizumab, omalizumab and reslizumab
  • asthma pharmacist clinic for patients who struggle with medication adherence and treatment side effects
  • combined asthma/rheumatology clinic for the treatment of the asthma-associated condition eosinophilic granulomatous polyangiitis (EGPA) and other eosinophilic lung diseases
  • asthma physiotherapy clinic for asthmatic patients with  breathing pattern abnormalities
  • clinical/health psychologist clinic
  • asthma metabolic diseases clinic for patients with co-morbid obesity, adrenal insufficiency and other conditions associated with chronic steroid use
  • adolescent asthma transition clinic (based at Evelina London Children’s Hospital)
  • combined asthma/allergy clinic
  • combined asthma/ear, nose and throat (ENT) clinic for asthmatic patients with refractory sinonasal disease.

  Asthma team

  • David Jackson – clinical Lead, consultant in severe asthma and eosinophilic lung diseases

  • Alexandra Nanzer-Kelly – consultant in severe asthma
  • Jaideep Dhariwal – consultant respiratory physician
  • Cris Roxas – asthma advanced nurse practitioner
  • Mariana Fernandes – asthma nurse specialist
  • Linda Green – asthma nurse specialist
  • Louise Thomson – asthma nurse specialist
  • Grainne D’Ancona – consultant pharmacist
  • Leyla Osman – clinical lead physiotherapist for respiratory
  • Kirsten Stewart-Knight – clinical psychologist
  • Claire Hopkins – consultant ENT surgeon
  • Sangita Agarwal – consultant rheumatologist
  • Rosario Caballero – consultant allergist
  • Leanne Markey – asthma pathway coordinator

• Chronic obstructive pulmonary disease (COPD) clinic

  Our COPD service includes a dedicated COPD clinic, assessment by different members of the team, pulmonary rehabilitation, long-term oxygen therapy assessment and ambulatory oxygen assessment.

  COPD team 

  • Amy Dewar – consultant respiratory physician 

  • Lynn McDonnell – clinical specialist physiotherapist – IRT lead

  • Milly Price – specialist physiotherapist – ambulatory oxygen lead 

  • Esme-Kate Bermingham – clinical nurse specialist – LTOT lead

  • Laura Crawfurd – specialist physiotherapist – PR and in-pt lead

  • Katie Ryan – specialist physiotherapist – IRT community lead

  • Jessica-Charlotte Doherty – COPD pathway coordinator

• Endobronchial ultrasound (EBUS)

  Endobronchial ultrasound (EBUS) is a minimally invasive procedure which offers an alternative to surgery. It involves the use of direct ultrasound image guidance through a bronchoscope (thin flexible telescope) to sample tissue from the lung airways and lymph glands.

  We have performed over 2,400 procedures and our results are among the best in the world. We provide linear and radial ultrasound directed sampling of lymph nodes and masses.

  EBUS team

  • George Santis – consultant respiratory physician

  • Ronan Breen – consultant respiratory physician

  • Ali Quinn – clinical nurse specialist

  • Imelda Espanillo – deputy clinical nurse specialist

  • Sam Smith – patient pathway coordinator

• General respiratory

  We welcome referrals to one of our general respiratory clinics where we can provide assessment, investigation and management of all respiratory conditions including referral into one of our specialist services if appropriate.

  All referrals are reviewed and investigations may be requested prior to the first appointment to aid rapid and accurate diagnosis. We have access to a full range of respiratory assessment including lung function, specialist respiratory radiology, diagnostic and interventional bronchoscopy and pleural ultrasound. Physiological tests include standard lung function (transfer factor tests, lung volumes and airways resistance measurements using the body plethysmograph and flow volume loops) and more specialist tests such as cardiopulmonary exercise tests, airway provocation tests, hyperventilation studies, fitness to fly studies, bronchodilator studies, sleep studies (including  full polysomnography), oesophageal pH tests (ambulatory) and oesophageal motility testing.

  General respiratory team

  • Ronan Breen – consultant respiratory physician
  • Anne Collett – consultant respiratory physician
  • Amy Dewar – consultant respiratory physician
  • Andy Jones – consultant respiratory physician
  • Rex Muza – consultant respiratory physician
  • Alex West – consultant respiratory physician

  • Johan Meurling – consultant respiratory physician

  • Deepan Sivakumar – consultant respiratory physician

• Interstitial lung diseases

  Our interstitial lung disease (ILD) service is an NHS England specialty tertiary referral centre taking referrals from London and the south east of England. We are provide a broad range of services for all ILD including joint clinics (seeing both respiratory and rheumatology consultants together), same day lung function and CT scanning where needed, anti-fibrotic service including drug monitoring clinics with ILD pharmacists and home delivery of medication, supportive and palliative care including oxygen assessment, weekly ILD meetings with specialist radiology, bronchoscopy and histopathology.

  ILD team

  • Alex West – respiratory consultant (service lead)

  • Boris Lams – respiratory consultant

  • Surinder Birring – respiratory consultant

  • Maria Kokosi – respiratory consultant

  • Bhashkhar Mukerjee – respiratory consultant

  • Amit Patel – respiratory consultant

  • Sangita Agarwal – rheumatology consultant

  • Patrick Gordon – rheumatology consultant

  • Louise Pollard – rheumatology consultant

  • Sabrina Bajwah – palliative care consultant

  • Michelle Mak – radiology consultant

  • Helen Cahill – respiratory and critical care consultant

  • Rebecca Preston – radiology consultant

  • Emma Maclean – histopathology consultant

  • Grainne D'Anconna – consultant pharmacist

  • Marium Naqvi – ILD specialist pharmacist

  • Jennifer Waldron – pathway coordinator

  • Elaine Lyons  – respiratory Pharmacist

  • Jo Dallas – ILD clinical nurse specialist

  • Ruth Perez Renon – deputy ILD clinical nurse specialist

• Lung volume reduction service and advanced airways disease service

  We offer a fully comprehensive advanced airways disease service. Including lung transplant assessment, lung volume reduction surgery and endobronchial lung volume reduction with valves and endobronchial coils.

  Lung volume reduction team

  • Amy Dewar – consultant respiratory physician
  • Phil Marino – consultant respiratory physician
  • Lukacs Veres – consultant thoracic surgeon
  • Patrick Murphy – consultant respiratory physician
  • Arjun Nair – consultant radiologist
  • Charlotte Fowler – consultant radiologist

• Pleural diseases 

  We offer a highly specialised pleural disease service (diseases affecting the lining of the lung) and also accept referrals from other centres in south east London. We also offer weekly one-stop combined specialist pleural disease and thoracic surgery clinics. Services we offer include:

  • level 1 and 2 medical thoracoscopies (day and inpatient)
  • pleural catheter insertion
  • managing malignant effusions (a build-up of fluid and cancer cells in the lungs)
  • managing pneumothoraces (a build-up of air in the lungs)
  • thoracic ultrasound, ultrasound guided pleural biopsies and peripheral lung biopsies
  • connective tissue disease related pleural disease service (together with the lung inflammation service)
  • management of complex persistent air leaks

  Pleural team

  • Deepan Sivakumar – consultant respiratory physician 
  • Lawrence Okiror – consultant thoracic surgeon
  • Janeth Naling – clinical nurse specialist
  • Jessica-Charlotte Doherty – patient pathway coordinator

• Pulmonary hypertension 

  Pulmonary hypertension team

  • Bhashkar Mukherjee – consultant respiratory physician

  • Phil Marino – consultant respiratory physician

  • Natali Chung – consultant cardiologist

  • Aimee Braime – consultant intensive care

  • Michelle Mak Sze Mun – consultant radiologist

  • Karen Breen – consultant haematologist (PH/thrombosis clinic)

  • Alex Corless – clinical nurse specialist

  • Imran Hafiz – specialist pharmacist

  • Hannah Douglas – consultant cardiologist

  • Adriana Villa – radiologist

• Pulmonary rehabilitation

  Pulmonary rehabilitation is an exercise and education programme that is designed to help patients with chronic respiratory conditions. Patients who are deemed suitable are enrolled into an eight week programme, with the aim of improving exercise capacity and symptom control. The programme is run with input from specialist physiotherapists, occupational therapists, clinical nurse specialists and dietitians.

  Pulmonary rehabilitation team 

  • Amy Dewar – consultant respiratory physician

  • Lynn McDonnell – clinical specialist physiotherapist

  • Laura Crawfurd – specialist physiotherapist – PR lead

  • Jeong-Su Lee – specialist occupational therapist – PR lead

• South London oxygen assessment

  Our oxygen service includes the assessment for and provision of long-term home oxygen therapy and ambulatory or portable oxygen. Patients who are referred will undergo formal assessment of their blood oxygen levels and if suitable, home oxygen therapy will be arranged by our team.

  Oxygen service team

  • Dr Amy Dewar – consultant respiratory physician

  • Lynn McDonnell – clinical specialist physiotherapist 

  • Milly Price – specialist physiotherapist – ambulatory oxygen lead

  • Esme-Kate Bermingham – clinical nurse specialist – LTOT lead

• Thoracic cancer including lung cancer

  Guy’s and St Thomas’ NHS Trust is a specialist referral centre for thoracic cancers including lung cancer. Respiratory medicine is an integral component of the multidisciplinary thoracic cancers team. 

  We accept referrals for the investigation of suspected lung cancer (suspected lung cancer should be referred directly via eRS). We provide specialist investigations (linear EBUS; radial EBUS; autofluorescent bronchoscopy; interventional bronchoscopy) for the diagnosis, staging and management of lung cancer.

  We work alongside medical and clinical oncologists, thoracic surgeons, nurse specialists, dieticians, physiotherapists, pharmacists and occupational therapists in multidisciplinary clinics in the new Guy’s Cancer Centre (See the lung cancer pages for more information).

  Thoracic cancer team 

  • George Santis – consultant respiratory physician

  • Ronan Breen – consultant respiratory physician

  • Kimuli Ryanna – consultant respiratory physician

  • Ali Quinn – clinical nurse specialist

  • Imelda Espanillo – deputy clinical nurse specialist

  • Sam Smith – patient pathway manager

  • Lawrence Okiror – consultant thoracic surgeon

• Tuberculosis (TB)

  TB is an infection which can affect any organ, but most commonly affects the lungs and lymph glands. It is an important notifiable condition and requires management by specialist TB services.

  We provide a range of services relating to the investigation and management of TB, including:

  • contact screening

  • port of entry screening
  • Public Health England referrals.

  TB team

  • Ronan Breen – consultant respiratory physician
  • Nick Price – consultant infectious diseases

  TB community nurse-led service 

  • Antonia Eboh – specialist nurse
  • Zenab Sesayellow – administrator