Oxford Special Airways Clinic

Oxford Special Airways Clinic provides specialist assessment for patients with more difficult airway problems, for example severe asthma, chronic cough and severe chronic obstructive pulmonary disease (COPD).

We care for local patients and patients referred from other regions, and provide a wide range of diagnostic tests and treatments for airways disease.

We are active researchers in the field with extensive clinical expertise and experience.

Our team

Who you will see

Respiratory clinician

To review your medications and assessment findings, and talk about different treatment options.

Professor Ian Pavord
Professor Timothy Hinks
Professor Nayia Petousi
Dr Andrew Chadwick
Clinical Lead
Katie (Catherine) Borg
Trainee Advanced Nurse Practitioner

Respiratory Research Nurse and Research Practitioner

The Research Nurse and Research Practitioner will:

review your inhaler technique and talk about any medication issues
explore ways to support your asthma control
start new treatments with you
provide telephone support
discuss current research studies with you.

Clinical Research Nurses

Laura Bermejo
Ron Lyder
Beverly Langford
Denise Fleming-Brown

Clinical Research Practitioners

Hafiz Mahmood
Kiran Kumari

Speech and Language Therapist (SLT)

A Speech and Language Therapist can look at any throat (laryngeal) disorders that may be causing cough and breathlessness.

Jordan Thomas
Highly Specialist Speech and Language Therapist and Clinical Lead

Pharmacist

A Pharmacist can review your medication and advise on possible alternatives.

Sarah Poole
Advanced Clinical Pharmacist Lead
Stilian Todorov
Specialist Pharmacist

Secretarial support

Rachel Russell-Sharp
Medical secretary

Other staff

You may also meet:

Visiting Clinical Fellows and rotational Registrars
Physiotherapists
Respiratory Physiologists (for lung function tests to check how well your lungs are working)
Radiologists

Severe asthma and COPD

Most of our patients continue to have unacceptable symptoms or serious attacks despite high intensity treatment. In this setting asthma and COPD can be difficult to tell apart. Our approach is to move away from the labels and concentrate more on identifying patterns of disease associated with treatment responses.

Once treatment has been optimised we do our best to help patients cope more easily with their residual symptoms.

One feature of severe asthma and COPD is that symptoms and tests of lung function become unreliable markers of a likely response to steroids. As a result, patients may be receiving far too much treatment (with associated side effects) or not enough, leaving them at risk of serious attacks.

We have found that objective measures of airway inflammation are much more reliable tests for determining optimum steroid treatment. These tests also identify patients who are likely to respond to some of the newer treatments available or in clinical trial development.

Many patients will have the opportunity to participate in clinical trials of new treatment.

Inducible Laryngeal Obstruction (ILO), Cough Hypersensitivity and Breathing Pattern Disorder (BPD)

These conditions can mimic the symptoms of asthma, and it is not uncommon to have been incorrectly labelled as having asthma, or for these conditions to also be occurring alongside asthma.

You might have been given inappropriate treatment in the past that you have found is ineffective and may be causing more harm than good.

If we believe patients have any of these conditions, we may refer you to see our Speech and Language Therapist, who specialises in disorders of the throat that affect breathing or cough, for an upper airway assessment.

To find out more about Upper Airways (Respiratory) Speech and Language Therapy please visit:

Inducible laryngeal obstruction - Northumbria Healthcare NHS Foundation Trust

We may also refer you to the Respiratory Physiotherapy Team.

For more information please visit:

Physiotherapy for Breathing Pattern Disorders

Chronic cough

A chronic cough is defined as one lasting more than eight weeks. This is a common and distressing condition. It particularly affects women between the ages of 45 and 55.

Many report a persistent dry cough with a sensation of throat irritation, particularly after exposure to changes in temperature or irritant fumes. Talking and laughing can also trigger cough. The problem is caused by a heightened cough reflex.

Usually a sinister cause for the cough will have been ruled out before referral. Most patients we see have had a cough for more than a year.

Common causes include a side effect of blood pressure tablets (ACE inhibitors such as ramipril, lisinopril, captopril and perindropril), asthma, nasal disease and acid refluxing from the stomach to the gullet and throat. However, in up to 40 percent of patients, none of these conditions are present and the cough is unexplained.

We are usually able to help patients with unexplained cough by reassuring them that they do not have a serious underlying lung condition, and working with them to develop strategies to control the cough.

We have an active research programme looking into the cause of chronic cough, and we hope that better treatments will become available in the future. Reassuringly, the longer-term prognosis of all cough syndromes is good.

Rapid Assessment Clinic

Sometimes it is unclear what is causing a patient's symptoms and therefore what the best treatment options are for them. In this situation we ask patients to contact our Rapid Assessment Clinic when their symptoms are worsening (or exacerbating).

We usually invite patients up for a face to face appointment to try and better understand what is driving their symptoms and better characterise their airways problem.

This helps us to provide individualised care and ensure patients are receiving the right treatment for them.

Your appointment

Appointments take place at the John Radcliffe Hospital either in Level 2 Outpatients Blue Area or Oxford Special Airways Clinic.

How to find the John Radcliffe Hospital

What to expect

You are likely to see multiple members of the team and have some tests done (see below), so please allow plenty of time.

How to prepare

Please bring all of your inhalers with you (if you take any) and a list of your current medications.

Please do not withhold your inhaler before coming to your appointment.

Tests

We nearly always need to do tests to assess your condition and look into possible causes.

These include:

simple breathing tests
blood tests
basic questionnaires
X-rays.

Research

For opportunities to participate in research, please search for 'Respiratory' at OUH Research

Occasionally we offer the chance to participate in a research bronchoscopy:

Tom's Research Bronchoscopy - YouTube

For more information about our researchers, please visit:

Find us and contact us

Directions to Oxford Special Airways Clinic

Oxford Special Airways Clinic is based at the John Radcliffe Hospital:

How to find the John Radcliffe Hospital

From Oxford Children's Hospital entrance

Take the lift opposite the Oxford Hospitals Charity desk up to Level 2
Exit the lift, walk straight ahead through the double doors, and turn right
Oxford Special Airways Clinic is the last door on the left

From Level 2 main entrance

Walk straight ahead down the main corridor, past the lift lobby and League of Friends Cafe
Follow signs to the West Wing, turning left at the end of the corridor
Continue straight ahead
Oxford Special Airways Clinic is the last door on the left