1. Service Overview

This service will be delivered by KC Respiratory Services Ltd, operated solely by Jenny Casey, Respiratory Nurse Specialist. Jenny is the sole provider and clinician delivering the service, which includes spirometry, FeNO testing, and full respiratory diagnostic support for general practices and Primary Care Networks (PCNs). There are no additional staff or subcontractors involved.

The service provides high-quality, community-based respiratory diagnostics to support accurate diagnosis and management of asthma, COPD, and other respiratory conditions.

2. Aims and Objectives

• Deliver expert-led respiratory diagnostics in the community
• Ensure timely access to spirometry and FeNO testing
• Improve diagnostic accuracy and reduce inappropriate prescribing or referrals
• Promote early and proactive respiratory disease management

3. Service Scope

3.1 Target Population

• • Patients aged 5 and above with suspected asthma
  • Adults with suspected COPD
  • Existing patients requiring reassessment for diagnostic clarity

3.2 Inclusions

• • Full clinical history taken
  • Pre- and post-bronchodilator spirometry
  • FeNO testing for asthma evaluation
  • Detailed diagnostic interpretation
  • Diagnostic report with treatment recommendations

3.3 Exclusions

• • Patients with active respiratory infections or unable to comply with testing
  • Patients needing secondary care-level investigations (e.g., complex interstitial lung disease)

4. Service Delivery by KC Respiratory Services Ltd

4.1 Service Locations

• • General Practice sites

4.2 Referral Process

• • Referrals from GPs or nurse practitioners.
  • One-hour appointments to be made by the GP practice

4.3 Clinical Standards

• • Spirometry to ATS/ERS 2019 standards
  • FeNO per NICE/BTS/SIGN 2024 Asthma Guidelines
  • Clinical interpretation provided by ARTP-certified professionals or respiratory nurse specialists

5. Staffing and Training

The service is provided exclusively by Jenny Casey, Respiratory Nurse Specialist, who is a nurse prescriber, ARTP-accredited to perform and report on spirometry and highly experienced in community respiratory diagnostics. (NMC No 87A1363E)

As a sole provider, Jenny is responsible for all patient-facing care, reporting, equipment handling, and governance processes.

6. Equipment

• All equipment provided and maintained by KC Respiratory Services Ltd
• Includes:
  • Calibrated PC spirometers and syringes
  • Approved FeNO devices ( Nobreath machine)
  • Single-use consumables to maintain IPC standards
  • Lap top

7. Record-Keeping and IT

• Reports securely uploaded and sent to referring practices for coding
• Diagnostic reports include:
  • Spirometry graphs and values
  • FeNO readings
  • Diagnostic impression supported by clinical history
  • All reports to be completed and sent to practices within 5 days of consultation

8. Clinical Governance

• KC Respiratory Services Ltd will ensure full compliance with CQC and GDPR requirements
• Ensure all mandatory training is up to date

9. Tariff / Pricing

The cost of service includes:

• Spirometry
• FeNO (if required)
• Full diagnostic report with treatment recommendation (if required)
• Equipment costs and consumables
• Accommodation

Total cost: £700 per clinic (up to 7 patients per day), plus mileage charged at £0.45 per mile

10. Equality and Accessibility

KC Respiratory Services Ltd commits to:

• Providing inclusive, accessible services
• Supporting patients with disabilities, learning needs, or language barriers
• Using translation or interpretation services as needed

12. Review and Updates

The specification will be reviewed if:

• New national guidelines are published (e.g., NICE, BTS/SIGN)
• There are changes in service scope or contractual arrangements

Practice Requirements:

• Send pre-appointment letters with necessary requirements before test to patients re withholding current inhaled medication and contraindications(this can be supplied by KC Respiratory Services)
• Allow one hour per patient appointment
• Seven patients in total 4 patients in morning session (08.30 to 12.30)
• Half hour blocked for lunch
• 3 patients in afternoon session (13.00 to 1600 )
• Half hour catch up 1600 to 16.30
• Provide patient with prescribed short acting bronchodilator (pMDI) for reversibility to bring to appointment
• No PSD is required as Jenny is a nurse prescriber.