Respiratory physiology · London
Spirometry and full pulmonary function tests, read by a consultant respiratory physician.
FEV1, FVC, DLCO, body plethysmography, FeNO. ATS/ERS 2019 standardised, GLI reference equations. From £180 for spirometry, £350-£650 for a full PFT.
Why patients choose us
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A real clinician on your enquiry
The same person stays with you from first message through consultant report and next steps.
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Independent by design
We never accept payment to influence which chest unit we recommend. Free to use.
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A vetted London network
Respiratory physiology units re-vetted every six months on equipment, technicians and reporting.
What lung function testing measures
Spirometry is the start. A full PFT is the full picture.
The right combination depends on your symptoms, referral question and any suspected diagnosis. We help you decide before you book.
Spirometry
FEV1 (forced expiratory volume in one second), FVC (forced vital capacity) and the FEV1/FVC ratio, with the full flow-volume loop. Standardised to ATS/ERS 2019, reported against GLI reference equations. Reversibility testing adds a repeat set 15 minutes after a bronchodilator to look for asthma. Race-neutral or race-specific z-scores are used to define the lower limit of normal (LLN).
Full pulmonary function test (PFT)
Spirometry pre and post bronchodilator, body plethysmography for absolute lung volumes (TLC, RV, FRC), and single-breath carbon monoxide gas transfer (DLCO / TLCO with KCO). Add-ons: MIP, MEP and SNIP mouth pressures for respiratory muscle strength, forced oscillation technique (FOT) for effort-independent airway mechanics, multiple breath washout (MBW) for small-airway ventilation heterogeneity, and FeNO for eosinophilic airway inflammation. Cardiopulmonary exercise testing (CPET) is a separate assessment on its own page.
When it is used
The questions lung function testing answers.
A DLCO drop with normal spirometry is a classic early warning sign. That is one of the many patterns a full PFT is designed to catch.
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Chronic cough or unexplained breathlessness
The standard first-line workup when symptoms have not settled with primary care management.
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Asthma vs COPD differentiation
Reversibility testing (>12% and >200 mL FEV1 improvement) separates asthma from fixed COPD obstruction.
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ILD monitoring
DLCO frequently drops before spirometry changes. Serial testing tracks disease trajectory and treatment response.
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Pre-operative fitness for lung resection
FEV1 and DLCO predict post-operative complications and guide surgical planning.
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Chemotherapy monitoring
Bleomycin, oxaliplatin and immune checkpoint inhibitors can cause pulmonary toxicity. DLCO is the sensitive marker.
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Occupational and medical surveillance
HGV, aviation, commercial diving and hazardous-dust surveillance all require standardised spirometry.
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Pulmonary hypertension screening
A reduced DLCO with preserved spirometry is a classic pattern that prompts echo and further workup.
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FeNO for eosinophilic inflammation
A raised FeNO supports an eosinophilic asthma phenotype and helps guide inhaled or biologic therapy.
Interpretation basics
What the numbers mean.
Your consultant explains everything in context. This is the short version.
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Obstruction
FEV1/FVC below 0.70 or below the lower limit of normal (LLN). Severity graded by FEV1 percent predicted.
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Reversibility
A post-bronchodilator FEV1 improvement of >12% and >200 mL supports asthma.
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Restriction
A reduced TLC on body plethysmography confirms true restriction. Spirometry alone cannot diagnose it.
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Impaired gas transfer
A reduced DLCO points to ILD, emphysema, pulmonary vascular disease or anaemia. Correction with KCO and alveolar volume aids the pattern.
Before your appointment
Preparation matters. Good technique matters more.
The test is technician-dependent. Coaching is what turns a valid effort into a valid result.
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Short-acting bronchodilators (SABA)
Withhold for 4 hours before reversibility testing where safe to do so.
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Long-acting bronchodilators (LABA)
Withhold for 12 hours before reversibility testing where safe to do so.
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Ultra long-acting (LAMA)
Withhold for 24 hours before reversibility testing. Never stop rescue medication without clinical advice.
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Caffeine
Avoid tea, coffee and energy drinks for 4 hours before testing.
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Food and smoking
No heavy meal for 2 hours. No smoking or vaping for at least 1 hour.
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Exercise and clothing
No vigorous exercise for 30 minutes before the appointment. Loose clothing that does not restrict the chest wall.
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Recent respiratory infection
Ideally wait 4-6 weeks after a chest infection unless the referrer specifically wants a baseline during illness.
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Bring your inhalers
List every device and dose. The physiologist needs to know exactly what you have taken and when.
Indicative pricing
Honest ranges across our partner units.
Send the details and we come back with two or three firm options in one working day.
| Test | Indicative range | Duration | Report |
|---|---|---|---|
| Spirometry alone (FEV1, FVC, FEV1/FVC, flow-volume loop) | £180-£320 | 30-45 min | 24-48 hrs |
| Spirometry with reversibility (pre and post bronchodilator) | £220-£380 | 45-60 min | 24-48 hrs |
| Full PFT: spirometry + lung volumes (body plethysmography) + DLCO | £350-£650 | 60-90 min | 48-72 hrs |
| FeNO (eosinophilic airway inflammation) add-on | £80-£150 | +10 min | Same day |
| MIP / MEP / SNIP (respiratory muscle strength) | £120-£240 | 20-30 min | 24-48 hrs |
| MBW (multiple breath washout) or FOT (forced oscillation) | £200-£400 | 30-45 min | 48-72 hrs |
| Full PFT bundle with consultant respiratory physician consultation | £450-£850 | 90-120 min | 48-72 hrs |
The journey
From enquiry to report, in order.
One concierge, start to finish. Usually under a week from first message to consultant report.
- 01 Before
You tell us what is going on
A short, confidential form. Symptoms, inhalers, referral or insurer if you have them.
- 02 Before
We come back with a recommendation
Within one working day: spirometry alone, full PFT, or a chest physician consult first. If lung testing is not the right step, we say so.
- 03 Before
We arrange the appointment
Often same or next week, evenings and Saturdays included. Insurer pre-authorisation handled.
- 04 On the day
Preparation and technique coaching
A trained respiratory physiologist explains each manoeuvre. Nose clip, mouthpiece, calibrated equipment with daily biological control.
- 05 On the day
The tests themselves
Spirometry alone runs 30-45 minutes. Full PFT with lung volumes and gas transfer runs 60-90 minutes.
- 06 On the day
Straight home
No recovery. Drive, eat and work as normal. Restart your usual inhalers.
- 07 After
Report and next steps
Consultant respiratory physician report in 48-72 hours, routed to your GP or specialist.
Our vetted London network
Where lung function is done well in London.
Introductions made privately, once we understand your case.
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CQC-registered respiratory physiology units with current good or outstanding rating
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Reporting by GMC-registered consultant respiratory physicians
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ATS/ERS 2019-compliant equipment with daily biological control and quality assurance
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GLI (Global Lung Function Initiative) reference equations with LLN and z-scores
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Reproducibility: minimum three acceptable ATS/ERS-compliant efforts per manoeuvre
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Royal Brompton Private Respiratory Physiology
National tertiary chest centre. Full PFT, MBW, FOT and complex ILD workups.
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Chelsea and Westminster Private Respiratory
Full PFT with same-week consultant clinics.
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HCA Wellington Chest
St John's Wood. Full pulmonary function suite and cardiothoracic multidisciplinary support.
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London Bridge Respiratory
HCA site with consultant respiratory physiology, imaging and biologics clinic access.
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One Welbeck Chest Imaging & Endoscopy
Marylebone. Modern PFT lab co-located with CT and bronchoscopy.
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Cromwell BUPA Chest
Kensington. Full PFT, FeNO and same-day consultant reporting.
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Guy's and St Thomas' Private Chest
Full PFT with strong ILD, PH and cystic fibrosis subspecialty support.
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London Medical
Marylebone. Streamlined spirometry and reversibility with rapid reporting.
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InHealth
Community diagnostic hubs across London for standardised spirometry and FeNO surveillance.
Related
The wider chest workup.
What often sits alongside lung function testing.
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Bronchoscopy
Direct airway visualisation with sampling for infection, inflammation or malignancy.
Read more -
Private CT scan
HRCT chest for ILD, emphysema and nodule characterisation.
Read more -
CPEX / CPET
Cardiopulmonary exercise testing. Covered on a separate page.
Read more -
Asthma biologics clinic
Anti-IgE, anti-IL5 and anti-TSLP therapy for severe eosinophilic asthma.
Read more -
Bronchial thermoplasty
For severe persistent asthma resistant to standard therapy.
Read more -
Asthma
Diagnosis, monitoring and modern step-up therapy.
Read more -
COPD
Fixed obstruction: diagnosis, phenotyping and treatment.
Read more -
Interstitial lung disease
ILD diagnosis, DLCO monitoring and antifibrotic therapy.
Read more
Frequently asked
What people ask before enquiring.
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Do I need a referral for spirometry or full PFT?
Spirometry and reversibility usually accept self-referral. Full PFT with lung volumes and DLCO is normally requested by a respiratory physician. We can arrange a rapid private chest consultation if you do not have one.
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How is spirometry different from a full PFT?
Spirometry measures FEV1, FVC and the FEV1/FVC ratio using a mouthpiece and a spirometer. A full PFT adds body plethysmography for true lung volumes (TLC, RV, FRC) and DLCO for gas transfer, plus optional respiratory muscle testing. Spirometry cannot diagnose restriction on its own.
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Should I take my inhalers before the test?
For reversibility testing, your team may ask you to withhold SABA for 4 hours, LABA for 12 hours and LAMA for 24 hours where safe. Never stop rescue medication without clinical advice. Bring every inhaler you use to the appointment.
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How accurate are the results?
Very accurate when performed to ATS/ERS 2019 standards on calibrated equipment with a trained physiologist and reproducible efforts (minimum three acceptable manoeuvres). Reports use GLI reference equations with the lower limit of normal (LLN) and z-scores rather than a fixed percent predicted.
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Will my insurance cover it?
Most policies cover lung function testing when medically indicated and pre-authorised. Bupa, AXA, Vitality, Aviva, WPA, Cigna and Healix are all recognised across our network. We handle pre-authorisation.
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Can I have FeNO on the same visit?
Yes. FeNO takes about ten minutes and is usually done first, before spirometry, to avoid manoeuvres influencing the reading. It is particularly useful when eosinophilic asthma is suspected.
Ready to book
Get spirometry, full PFT or FeNO in a London chest unit that gets the technique right.
Tell us what is going on. We reply within one working day with a clinician-led recommendation and a firm quote. Free.