Respiratory Medicine

Respiratory medicine lung image

We provide all general respiratory services for patients, whether your condition is minor, manageable, chronic or life-threatening.

About us

Respiratory medicine is concerned with the diagnosis and treatment of a wide variety of diseases of the airway and lungs, their linings and blood vessels, and the muscles and nerves required for breathing.

Respiratory physicians treat patients holistically and always endeavour to involve patients in their own care. Patient education and self-management is key to the treatment of many respiratory conditions.

As a result of your condition, you may need to be admitted as an inpatient. Our respiratory medicine department at Pinderfields Hospital includes two specialist respiratory wards, Gate 45A and Gate 45B, Gate 11 and a 14-bed medical acute respiratory care unit (ARCU) providing non-invasive ventilation (NIV) for respiratory failure, as well as many other respiratory conditions that require close monitoring. Respiratory specialists also do daily ward rounds on our acute admission unit on Gate 12.

Our chest clinics are held at all three sites; Dewsbury and District Hospital, Pinderfields Hospital and Pontefract Hospital. Due to Covid-19, clinics are also being carried out via a video link or telephone call.

We work alongside a multi-disciplinary team (MDT) of specialist nurses, physiologists, pharmacists, psychologists and physiotherapists. For more information about some of our specific teams please see below.

Our respiratory physiology labs are equipped with state-of-the-art equipment including cardiopulmonary exercise testing, a body box and facilities for polysomnography.

Conditions we treat

The range of conditions encompass:

  • Asthma
  • Bronchiectasis
  • Chronic obstructive pulmonary disease (COPD)
  • Interstitial lung disease
  • Lung cancer
  • Lung infections including tuberculosis
  • Sleep related breathing disorders
  • Non-invasive ventilation and respiratory failure

Asthma

Our difficult asthma service was founded in 2011 and has been recognised by the British Thoracic Society and Asthma UK amongst others. We are a core member of the regional Yorkshire Asthma MDT, as well as having our own local multi-disciplinary team incorporating clinicians, nurses, clinical psychologists, physiologists, pharmacists, physiotherapists and ENT specialists.  We have extensive experience in treating patients with biologic therapies most of which are now initiated and administered at the patient’s home. We actively participate in research and clinical trials.

Asthma self-management

In a bid to tackle health inequalities across the region, in August 2021, one of our Respiratory Consultants secured a £150,000 research grant to help tackle language barriers for patients with asthma whose first language isn’t English and those with low literacy skills (read more here.)

The money was used to create a suite of multilingual resources for asthma sufferers with literacy and language barriers, allowing individuals to be more informed in managing their asthma care. Below you can find a range of multilingual videos aimed at asthma self-management.

Bronchiectasis

Bronchiectasis is one of the most common, yet unrecognised, respiratory conditions. We are developing this service with support of a complex infection MDT and respiratory physiotherapists. Intra-venous (IV) antibiotics are available via an efficient home IV antibiotics service.

Chronic obstructive pulmonary disease (COPD)

The COPD team deal with patients with severe COPD who may need specialist treatments. As well as providing support for community teams, the Mid Yorkshire COPD service can provide assessment for possible COPD surgery, working closely with the regional COPD surgery team in Leeds. The team can also provide non-invasive ventilation support at home for those that require it.

Home ventilation

The team consists of specialist respiratory doctors and nurses and physiotherapists who assess the need for support of patients’ breathing muscles, providing ventilatory support and monitoring patients who need home ventilation. The team aim to provide as much of the care at home as is possible. The team also provide support at home for people with complex disabilities.

Interstitial Lung Disease (ILD)

The ILD team participate in both local and regional MDTs. The close links with the regional centre at Leeds ensures that highly specialised care can be delivered locally. The team are able to provide shared care for patients on anti-fibrotics.

Sleep disorders

The team consists of physiologists, nurses, and doctors who diagnose and treat a range of sleep disorders, predominantly Obstructive Sleep Apnoea - a common condition which causes severe snoring and daytime sleepiness. For further information, visit our Sleep Service webpage.

Tuberculosis (TB)

Tuberculosis is a disease caused by infection with TB bacteria (mycobacterium tuberculosis).

The Mid Yorks Tuberculosis Clinics (TB) are held weekly In Dewsbury and Pinderfields.

We offer an integrated service including diagnosis and treatment of active Tuberculosis and Latent Tuberculosis Infection, and screening for people who have been in contact with tuberculosis.

We aim to provide holistic care for patients and their families, with support in the clinic from the specialist TB Health Visitor team. The TB Health Visitor team provide on-going support to patients and their families. They can help with concerns about medication including support for completing the course (with Directly Observed Therapy when necessary) and possible side effects.

If you live in Kirklees their contact telephone number is available for any concerns and messages may be left out of hours - 030 330 9869.

The team

Our consultants are:

  • Dr Ali Ameri
  • Dr Parry Blaxill
  • Dr Sarah Boot
  • Dr Akshay Dwarakanath
  • Dr Husham Elfaki
  • Dr Georgina Esterbrook
  • Dr Anjali Gondker
  • Dr Joseph Hogg
  • Dr Laura Horgan
  • Dr Owen Johnson
  • Dr Llinos Jones
  • Dr James McCreanor
  • Dr James Quinn
  • Dr Graham Smith – Head of service
  • Dr Ian Sutcliffe
  • Dr Muthu Thirumaran
  • Dr Kate Williams
  • Dr Muhalab Yousif 

What our patients say

Patients say

Every staff member went above and beyond for my care in gate 27 and 45b, I will be forever grateful.

Patients say

Good knowledgeable staff with a quick response and appointment bang on time!

Patients say

Everyone was kind and welcoming. Excellent care from nurses and the Doctors and consultants. Very good meals.

Patients say

I was really down due to feeling rubbish, due to the illness, and the fact my wife wasn't with me, but every single nurse, and other staff were wonderful, they always had a smile, and very up-beat and jovial. They kept me smiling, and nothing was too hard for them to help me keep comfortable, If I needed help washing they helped me, and when I felt embarrassed when asking for help with silly little things they reassured me that it wasn't a problem to them.

Patients say

To be honest, I don't have one single bad word to say about the staff, they were brilliant in every way, and I am very thankful for everything they have done to get me well, and back home. It was a lonely time without my family visiting, but the staff did everything possible to help me through it and I'm very thankful. Hopefully I won’t have to go back to hospital due to meningitis, but if I do, I hope I'm lucky enough to be on ward 45b.

Key achievements

In 2019 the Respiratory Team were ‘Clinical Team of the Year’ in our Celebrating Excellence awards.  We believe that we have continued to provide a high standard of care despite the challenges of the pandemic.

One of our Respiratory Consultants has successfully secured a £150,000 research grant to help tackle language barriers for patients with asthma whose first language isn’t English and those with low literacy skills. The £150,000 grant was secured through The NHS Accelerated Access Collaborative’s ‘Pathway Transformation Fund’ and was the result of a working partnership between Consultant Respiratory Physician, Dr Llinos Jones and the Yorkshire and Humber Academic Health Science Network (AHSN).

The money will be used to create a suite of multilingual resources for asthma sufferers with literacy and language barriers, allowing them to be more informed and involved in the decisions they make in regard to their asthma care.

We are involved with ongoing research including RASPER, ASPECT, BEACON IPF.

In January 2020 all of the respiratory consultants took part in a challenge to walk the distance from Lands’ End to John O’Groats to raise over £8000 for the Acute Respiratory Care Unit.

Pinderfields Emergency Respiratory Team (PERT)

The PERT Team is made up of clinical nurse specialists (CNS), respiratory physiotherapists, advanced support workers and administrative support.

The PERT Team provide an inpatient respiratory nursing service for all patients admitted to hospital with an exacerbation of COPD or Asthma, and a Community Respiratory Nursing Service to patients with a respiratory diagnosis who are within the Wakefield CCG and North Kirklees CCG area.

Our PERT service:

  • offers support and treatment to patients with exacerbation of COPD to prevent them from being admitted to hospital. We accept referrals from GP’s, Yorkshire Ambulance Service (YAS), Community Healthcare Professionals and self-referrals
  • provides an early supported discharge service, for all patients admitted to hospital with a respiratory illness (who meet certain criteria).  Patients are cared for in their own homes receiving acute treatment as they would in hospital
  • reviews all patients admitted with an exacerbation of COPD
  • provides in-depth education to patients with an exacerbation of COPD and asthma ensuring they have the skills and knowledge to enable them to self-manage their condition
  • reviews all patients admitted with an exacerbation of asthma
  • checks inhaler technique and optimisation of respiratory treatment
  • promotes smoking cessation and make appropriate referrals
  • provides a community home non-invasive ventilation (NIV) service for approximately 380 patients
  • provides an acute NIV service – assisting with the initiation of acute inpatient NIV sets ups for patients in acute type 2 respiratory failure and facilitating transfer to ARCU
  • completes in-patient long-term oxygen therapy (LTOT) assessments and risk assessments and then referring on to the appropriate LTOT team
  • supports NIV and MND outpatient clinics
  • provides outpatient sleep investigations
  • provides a pulmonary rehabilitation service for patients in North Kirklees
  • provides Respiratory Physiotherapist reviews for patients in North Kirklees

provides support and education to patients, carers and all colleagues. 

Lung Cancer

Our lung multidisciplinary team (MDT) is one of the largest in the country - with over 500 patients diagnosed every year. 

Clinics are held in all three hospitals sites, and we have excellent access to a range of diagnostic investigations including bronchoscopy, EBUS, CT guided biopsy and ultrasound guided biopsy; we were the first trust locally to have a medical thoracoscopy service. During covid video consultations were introduced with positive patient feedback.

The consultants work with a dedicated team of lung clinical nurse specialists supported by a care co-ordinator and pathway navigator. Treatments such as surgery and radiotherapy are provided by the Leeds Teaching Hospitals NHS Trust whilst chemotherapy can be delivered in Pontefract and Dewsbury.  

There is an established survivorship clinic for patients after surgery, access to a MacMillan hub for advice and support and a regional mesothelioma nurse specialist for support and to improve access to clinical trials.

The team participate in the national lung cancer audit in order to highlight good practice and identify areas for improvement.

Lung cancer nurse specialists support patients and their relatives and carers through all stages of their illness from diagnosis to end of life.

They provide:

  • Information and advice about cancer and its treatments.
  • Emotional support in dealing with diagnosis.
  • Help with controlling symptoms.
  • Helpful contact with other staff and services involved with patient care.
  • A resource for provision of financial and social support.

Respiratory Nurse Specialists

The Respiratory nursing team is made up of specialist nurses: Karen Schofield, Jessica Quarmby, Mandy Jeffery, Andrea Backhouse, Claire Hopkins, Jodie Silver and Jane Reader with admin support from Deborah Wain.

The Respiratory nurses:

  • Have their own outpatient clinics, over all three sites, reviewing patients with all respiratory conditions including asthma and COPD ward discharge clinics.
  • See patients at home for case management, to provide education, support and to try and prevent readmission.
  • Work alongside other members of the MDT in the community including GPs, District Nurses, Macmillan nurses and physiotherapists when patients are approaching the end of their life.
  • Manage the Home oxygen service for Wakefield.
  • Work closely with Dr Jones and Dr McCreanor and the asthma MDT as well as running a biologic injection clinic.
  • Provide education and training for nebulised drugs such as colomycin.
  • Support patients with Interstitial Lung Disease by attending the ILD clinic, running their own clinics and a support group.
  • Provide educational sessions at Pulmonary Rehab.

Sleep and ventilation

We provide a Sleep Service for the residents of Wakefield, Kirklees and Barnsley. Our role is to assess people who have symptoms of Obstructive Sleep Apnoea (OSA), make an accurate diagnosis and advise on the treatments available. 

As well as OSA, we also deal with patients with other sleep and ventilation conditions. Our home ventilation team support around 350 patients currently.

The Sleep service provides clinics at Dewsbury and District Hospital and Pontefract Hospital, with the more complex investigations and treatments carried out on the Pontefract site.  

We see about 800 new referrals each year and have about 5000 patients on CPAP therapy, the treatment of choice for moderate to severe OSA.

Consultants — Dr Akshay Dwarakanath

Specialist Physiologist - M/s Amanda Peace

Specialist nurses - Lesley Earnshaw, Cheryl Smith, Corrine Legway, Angela UpsonHealth care scientist-Beoley Garbutt 

Administrator - Michelle Bedford

Snoring and Obstructive Sleep Apnoea (OSA) are common complaints. Snoring is not generally considered to be a serious medical problem, but it can be a nuisance as the noise can disrupt the sleep of a bed-partner and put relationships under strain.

OSA is a medical condition associated with severe symptoms and long-term health consequences.

The role of the Sleep Service is to correctly diagnose which of the two conditions the patient is suffering from and advise on the best treatment for them.

For more information about OSA and driving please visit the DVLA website.