Lane Fox respiratory service
All NHS GP referrals must be submitted using the NHS e-Referral Service (e-RS). Referrals sent by email or post from NHS GPs will not be processed.
Please email referrals for outpatient assessment of chronic respiratory failure.
Please include information about your patient's:
- current issue and any relevant background history
- infection status
- tracheostomy status
- ventilator settings
Motor neurone disease referrals
Please complete the referral form.
For an inter-hospital transfer for an inpatient with motor neurone disease, please use the e-referrals system.
Inpatient transfers for level 2 non-invasive ventilation and level 3 weaning from invasive mechanical ventilation
For inter-hospital transfers, please complete the e-referrals form on Teleologic.
Please include a detailed medical referral letter as a PDF attachment. Please also make sure the patient's infection control status is clearly stated, including:
- Clostridium difficile (C. diff)
- Candida auris
Please note that you need to have an nhs.net email address to refer using the e-referrals form.
To discuss suitability of referrals for the service or for clinical advice, please contact the main switchboard, phone 020 7188 7188 and ask for the on-call Lane Fox consultant.
Please email urgent outpatient referrals to us and include details about why the referral is urgent.
For urgent inpatient transfer requests, please contact the main switchboard, phone 020 7188 7188 and ask for the on-call Lane Fox consultant.
Lane Fox referral and transfer policy
We admit patients to the Lane Fox respiratory unit at St Thomas' Hospital or the Lane Fox Remeo respiratory centre at East Surrey Hospital. We expect the patient to be transferred to the Lane Fox Remeo respiratory centre after 1 or 2 weeks. We may transfer patients back to their local hospital if weaning is not possible after this assessment period.
All referral forms need to be accompanied by a referral letter.
Our on-call Lane Fox consultant and the nurse in charge will call the transferring centre for weekly updates and to give weaning advice.
Our on-call Lane Fox consultant will work with our home ventilation service each week to decide which patients can be directly transferred to a nursing home (for example, high spinal cord injury, traumatic brain injury) to avoid admission to the Lane Fox service.
Important transfer information
We'll prioritise the transfer of patients with:
- chronic respiratory, such as chronic obstructive pulmonary disease or bronchiectasis
- chest wall deformities
- neuromuscular conditions, such as:
- Guillain-Barre syndrome
- Duchenne's muscular dystrophy
- motor neurone disease
- limb girdle muscular dystrophy
Patients with post-sepsis multi-organ failure and associated muscle weakness without a chronic respiratory condition will receive lower priority.
We'll consider carefully the transfer of level 3 patients who have a 'do not attempt to resuscitate' or a 'not for escalation' order in place at their local hospital. We'll discuss with the referring consultant and prioritise accordingly.
Please complete all parts of the referral form and include a standard referral letter.
For referrals from other hospitals, please include a completed inter-provider minimum data set or send it within 48 hours of referring a patient.
Please include in the referral letter:
- the cardiac status of the patient, including the report of a recent electrocardiogram and echocardiogram
- the infection status of the patient, including multiple drug-resistant infections such as MRSA, Candida Auris, CRO and VRE
- if the patient has had previous Clostridium Difficile toxin positive diarrhoea and the stool type (for example, type 1 through type 7 stool consistency)
When the patient is transferred to Lane Fox unit or Lane Fox Remeo centre, please send all patient images by image exchange portal (IEP).
We cannot accept patients with:
- active delirium
- FiO2 greater than 0.4, unless there is a consultant-to-consultant discussion
- untreatable infection, such as pulmonary, pleural and peritoneal infection
Last updated: October 2023