{
  "abstract": "Introduction A requirement of the community diagnostic centre (CDC) programme, launched by National Health Service England in 2022, was to receive and process referrals from both primary and secondary care providers. 1 In June 2024, we initiated our direct-to-test lung function referral service for General Practice (GP) surgeries in East Sussex with the help of the Integrated Care Board. Prior to this, referrals for lung function investigations at our CDC could only be made by secondary care.The Service The investigations are predominantly performed by band 3 Cardiorespiratory Technicians, with same day reporting and interpretation by a Clinical Respiratory Physiologist. Available investigations are spirometry, bronchodilator responsiveness (BDR) and fractional exhaled nitric oxide (FeNO). Indications for referral are query asthma, query chronic obstructive pulmonary disease (COPD), targeted lung health check (TLHC) or any combination of these. Referrals are triaged and booked by lung function administration.Methods A retrospective review of clinic activity data from June 2024 to June 2025.Results Between June 2024 and June 2025 the service received 781 referrals from 18 East Sussex GP surgeries, with 473 appointments booked during this time and 388 patients tested. 435 individual patients were booked during this time. The most common indication was ‘?COPD’ (n=208) and most common test performed was spirometry (n=366). Unfortunately 18.8% of appointments were either UTA or DNA (n=85). Of the 254 BDR tests performed, 24.4% were significant and 16.8% of FeNO tests were ≥50ppb. See table 1.Important Findings and Conclusion Our GP direct-to-test pathway has been a heavily utilised and important service for patients and local GP surgeries. Important findings include receiving 118 inappropriate or erroneous referrals, poor attendance, challenges with training multiple cardio-respiratory staff and creating and delivering a new primary care service alongside an already busy lung secondary care lung function department. It was also interesting to note the prevalence of mental health history on referral forms in 46.9% of patients, highlighting a link between respiratory symptoms and mental health.Reference Community diagnostic centres: Guidance for planning, design and implementation. NHS England. https://www.england.nhs.uk/long-read/community-diagnostic-centres/Abstract P64 Table 1Selection of important data collected from initial 12-month period of our direct-to-test GP lung function pathwayNumber% of TotalAppointments Booked473Patients Tested38882.0DNAs5511.6Females Referrals19954.3Male Referrals23645.7Asthma Referrals11426.2COPD Referrals20847.8TLHC Referrals153.4Combination Referrals9822.6Spirometry Tests Performed366FeNO Tests Performed196BDR Tests Performed254",
  "authors": [
    {
      "affiliations": [
        "East Sussex Healthcare NHS Trust, St Leonard’s-on-Sea, United Kingdom"
      ],
      "name": "Luke Youngs"
    },
    {
      "affiliations": [
        "East Sussex Healthcare NHS Trust, St Leonard’s-on-Sea, United Kingdom"
      ],
      "name": "Robyn Inskip"
    }
  ],
  "title": "P64 GP direct-to-test lung function pathway – 12-month service review",
  "uid": "a8ebcdf3-0789-586a-a57e-8123af998708"
}