Concierge respiratory physiology · London
Lung function testing, the modern menu — spirometry, gas transfer, lung volumes, FeNO, bronchial challenge and CPET.
A patient-facing menu of respiratory physiology tests — spirometry, gas transfer (TLCO), lung volumes, FeNO, bronchial provocation and cardiopulmonary exercise testing (CPET). Choose the right test for your symptoms and pre-operative planning.
Why patients choose us
- 01
The right hands
We route you to a consultant respiratory physician — the person who chooses the menu and reads the physiology decides the answer.
- 02
Often bundled same-day
Spirometry, gas transfer and lung volumes can usually be run in a single respiratory day appointment.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
What lung function testing is, at a glance.
A menu of respiratory physiology tests, chosen by the clinical question and reported by a consultant respiratory physician against GLI reference equations.
In short
A bundled respiratory day appointment, ERS/ATS-aligned, reported within 48 hours.
| Key fact | What it means | Typical scope | Report turnaround |
|---|---|---|---|
| Menu of respiratory physiology tests | Bundled quote | Half-day | 48 hours |
| Choose by clinical question, not by list | Consultant-led | Tailored | 48 hours |
| Bundled respiratory day appointment | £650–£1,200 | 2–3 hours | 48 hours |
| ERS/ATS-aligned protocols | Included | Per test | 48 hours |
| Consultant respiratory reporting | Included | — | 48 hours |
| Pre-op assessment or diagnostic use | £450–£1,800 | Half-day | Same-week |
The exact bundle depends on the clinical question. We come back with a firm quote within one working day, and a written schedule for withholding bronchodilators before the visit.
The problem
A physiology test is only as good as the menu it belongs to.
Spirometry alone answers a narrow question. The full menu — gas transfer, lung volumes, FeNO, bronchial challenge and CPET — answers the clinical one. We route you to a consultant respiratory physician who chooses which of them you actually need.
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Suspected asthma or COPD?
Spirometry with reversibility and FeNO — phenotype the disease, don’t just label it.
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Breathlessness of unclear cause?
TLCO and, when indicated, CPET — the integrated answer, not a single number.
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Pre-op or ILD surveillance?
Spirometry, TLCO and lung volumes — with the trajectory tracked over serial studies.
The pathway
From consultation to structured plan — what happens, in order.
Seven steps: consultation, test menu, bronchodilator schedule, baseline demographics, sequential testing, GLI reporting, structured plan.
Phase 1 · Before your visit
Consultation and preparation
Phase 2 · On the day
~2–3 hours in the physiology lab
Phase 3 · After
Reporting and structured plan
- 01
Before
Respiratory consultation
A consultant respiratory review sets the clinical question — asthma, COPD, ILD, pre-op or breathlessness of unclear cause.
- 02
Before
Choose the test menu
Spirometry, gas transfer (TLCO), lung volumes, FeNO, bronchial provocation or CPET — matched to the clinical question, not bundled by default.
- 03
Before
Withhold bronchodilators if requested
You’ll be asked to withhold short- and long-acting bronchodilators for a defined window before the visit — we send a written schedule.
- 04
On the day
Baseline demographics
Height, weight, age, sex and ethnicity are recorded — GLI reference equations depend on them.
- 05
On the day
Sequential testing
Tests run in order: spirometry → gas transfer (TLCO) → lung volumes, with FeNO, bronchial challenge or CPET added as indicated.
- 06
After
Reported per GLI
Results reported against Global Lung Function Initiative (GLI) reference equations — with z-scores and % predicted values.
- 07
After
Structured plan
A consultant respiratory report with a structured plan — inhaler therapy, biologics review, anti-fibrotic pathway or MDT referral as needed.
Typical end-to-end: 5–10 days. Report turnaround: 48 hours.
What it shows
The eight things lung function testing tells us.
Each test on the menu answers a specific physiology question — airflow, gas transfer, volume, inflammation, hyper-responsiveness or exercise limitation.
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Spirometry FEV1/FVC
The core measurement — forced expiratory volume in 1 second and forced vital capacity, the airflow-obstruction signal.
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Gas transfer (TLCO)
How well oxygen crosses from alveoli into blood — sensitive to ILD, emphysema and pulmonary vascular disease.
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Lung volumes (TLC, RV)
Total lung capacity and residual volume — distinguishes restrictive from obstructive physiology.
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Small-airway function (FEF25–75)
Mid-expiratory flow rates — an early signal of small-airway disease before FEV1 drops.
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FeNO for airway inflammation
Fractional exhaled nitric oxide — a marker of eosinophilic airway inflammation in asthma.
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Bronchial provocation (methacholine)
A challenge test to confirm or exclude airway hyper-responsiveness when spirometry is normal but asthma is suspected.
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CPET (peak VO₂)
Cardiopulmonary exercise testing — the integrated answer to breathlessness of unclear cause and pre-op risk.
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Red flag: rapid FEV1 or TLCO decline — respiratory MDT
A fast fall in FEV1 or TLCO between studies is not a repeat-test problem — it is an MDT referral.
Treatment options
What the physiology answer unlocks.
A physiology answer isn’t the destination — it’s the door to a plan. These are the treatment routes the numbers most often open.
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Bronchodilator therapy
Short- and long-acting bronchodilators — the physiology answer tells us which class and how to titrate.
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Inhaled corticosteroid
ICS choice and dose is driven by FeNO, spirometry response and eosinophilic markers — not by symptom score alone.
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Biologics for severe asthma
Anti-IgE, anti-IL-5 and anti-TSLP — considered when the physiology and biomarkers confirm severe eosinophilic disease.
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Anti-fibrotic therapy
Pirfenidone or nintedanib for progressive fibrosing ILD — the TLCO trajectory is the key signal for review.
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Pulmonary rehabilitation
A structured exercise and education programme — physiology-defined benefit for COPD, ILD and post-COVID lung disease.
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Smoking cessation
The single highest-yield intervention — the physiology trajectory changes decisively when smoking stops.
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Home NIV assessment
Non-invasive ventilation at home for hypercapnic respiratory failure — assessed against arterial blood gas and sleep physiology.
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Structured follow-up
Repeat physiology at defined intervals — the point is trajectory, not a single snapshot.
Our vetted London network
A small panel of physiology labs, we picked them.
Consultant respiratory partners across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every physiology lab in our network.
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Consultant respiratory physicians reporting the physiology
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ATS/ERS technical standards enforced by the physiology lab
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GLI reference equations for spirometry, TLCO and lung volumes
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Onward respiratory MDT pathway if severe or progressive disease is found
Red flags
When the physiology answer changes the plan.
These nine patterns are the ones where the lung function menu shifts the whole treatment conversation — not just adjusts a dose.
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Severe airflow obstruction
When FEV1 is severely reduced, the plan is inhaler optimisation, pulmonary rehabilitation and — if indicated — biologics or LVRS assessment.
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Hypercapnic respiratory failure
A rising CO₂ on blood gas is a home-NIV conversation, not another spirometry loop.
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Rapid TLCO decline (ILD)
A fast fall in gas transfer is the ILD trigger — HRCT and MDT review, with anti-fibrotic assessment on the table.
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Post-COVID lung disease
Persistent breathlessness after COVID warrants TLCO and CPET — not just repeat spirometry.
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Suspected occupational lung disease
Symptom–work correlation, serial peak flow and specific challenge testing — the history matters as much as the physiology.
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Alpha-1 antitrypsin deficiency
Early-onset emphysema or a family history triggers alpha-1 phenotyping — a single blood test with major implications.
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ACOS (asthma–COPD overlap)
Fixed obstruction with reversibility and eosinophilia — treated as neither pure asthma nor pure COPD, but by the physiology.
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Severe eosinophilic asthma
High FeNO, high blood eosinophils and steroid-dependent disease — the biologics conversation belongs here.
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Interstitial pneumonia with hypoxia
Resting or exertional desaturation with a restrictive TLCO drop — same-week HRCT and respiratory MDT.
Reading your report
A lung function report can look intimidating. It isn’t.
Whatever the pattern, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and demographics
Your details, the clinical question and the GLI reference set applied — height, weight, age, sex, ethnicity.
- 02 Technique
Protocol and quality grade
Which tests were run, ATS/ERS quality grade, number of acceptable manoeuvres and whether bronchodilator was withheld.
- 03 Findings
FEV1, FVC, TLCO, lung volumes
Absolute values, % predicted and z-scores — with the pattern (obstructive, restrictive, mixed) called out explicitly.
- 04 Impression
The conclusion: read this first
The pattern, the severity, the trajectory versus prior studies, and the concrete next step — read this first.
Sources
The guidelines behind this page.
Reviewed by Pulse Atlas Editorial Board (). Next review: 2027-07-30.
- NICE. Asthma: diagnosis, monitoring and chronic asthma management (NG245).
- NICE. Chronic obstructive pulmonary disease in over 16s: diagnosis and management (NG115).
- European Respiratory Society / American Thoracic Society. Technical standards for lung function testing.
- British Thoracic Society. Guidelines and quality standards.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about lung function testing.
Quick answers on the menu, inhaler withholding, bronchial challenge safety, and how quickly the physiology report lands.
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What is lung function testing?
A menu of respiratory physiology tests that measure how well the lungs move air (spirometry), transfer gas (TLCO), hold volume (lung volumes), signal inflammation (FeNO), respond to a challenge (methacholine) and perform under load (CPET). The point is to choose the right test for the clinical question, not to run them all by default.
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How is this different from a single lung function test?
A single lung function test is usually spirometry alone. Lung function testing as a menu adds gas transfer, lung volumes, FeNO, bronchial challenge or CPET when the clinical question needs them — for example, TLCO for ILD, FeNO for asthma phenotyping, CPET for unexplained breathlessness.
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Do I need to withhold my inhalers?
Usually yes — short-acting bronchodilators for around 4 hours and long-acting agents for 12–24 hours before the visit, unless your consultant advises otherwise. We send a written schedule tailored to your inhaler list.
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Which tests do I need?
That is the consultant respiratory physician’s call, driven by your clinical question. Asthma phenotyping typically needs spirometry, reversibility and FeNO; ILD needs spirometry, TLCO and often lung volumes; unexplained breathlessness or pre-op risk often needs CPET.
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Is bronchial challenge testing safe?
Methacholine challenge is safe when run to ERS/ATS technical standards in an accredited lab, with a physician-led stopping protocol and reversal on hand. It is not run when spirometry is already severely reduced.
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How quickly will I get results?
A structured consultant respiratory report is typically issued within 48 hours of the visit, with the impression and plan on the first page.
Related tests
Looking for a different test?
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Lung function test
The single-visit spirometry-led lung function test — start here for asthma or COPD assessment.
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Gas transfer
TLCO — how well oxygen crosses from alveoli into blood.
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Lung volume tests
Total lung capacity and residual volume — the restrictive/obstructive distinction.
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All tests
Browse every test and procedure we arrange.
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Asthma
Related condition guide.
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COPD
Related condition guide.
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Continuous Positive Airway Pressure
Related treatment option.
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Complementary Alternative Medicine
Related treatment option.
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In practice, in London
Where lung function testing sits in a private London pathway
With lung function testing, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The wait for lung function testing on the NHS depends heavily on where you live and how urgently the referral is graded. Central and West London private clinics can normally book within a week, with imaging or a procedure slot to follow shortly after. It’s worth being honest about the reason for going private: usually it’s time, not a fundamentally different test.
In practice, a private lung function testing appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Most of the imaging suites and endoscopy units we use sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For lung function testing specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
We’re careful about what a private pathway for lung function testing can and can’t promise. It can compress a wait, put you in front of a subspecialist quickly, and get a proper report in your hands within a week. It can’t rewrite what the imaging or the bloods say. Setting that expectation up front tends to make the whole experience less stressful.