Skip to main content

Respiratory physio - clear the airways, retrain the breath.

Consultant-referred and self-referred respiratory physiotherapy - airway clearance for bronchiectasis and CF, breathing pattern retraining for breathlessness, and structured pulmonary rehab. Delivered by cardiorespiratory-trained physios, in clinic or at home.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private respiratory physiotherapy costs in the UK.

Indicative ranges across our respiratory physio network - clinic-based, home visits and 8-week pulmonary rehab programmes.

In short

£95–£150, usually 45 minutes.

Procedure Indicative range
Initial respiratory assessment (60–90 min) £180–£280
Follow-up session (45 min) £95–£150
Home visit (Greater London) £180–£320
Pulmonary rehabilitation programme (8 weeks) £950–£1,800
Breathing pattern retraining course (6 sessions) £620–£1,100
High-frequency chest wall oscillation vest (rent/purchase) £2,800–£12,000
Cardiorespiratory consultation only £220–£380

Prices vary by therapist seniority, by location (home visits carry a premium), and by device prescription. Pulmonary rehabilitation and airway clearance devices are always the top of the range.

The problem

The right technique, the right diagnosis, the right frequency.

Respiratory physio is where general physiotherapy quietly under-delivers - MSK physios attempting airway clearance, breathing exercises given without diagnosis, and pulmonary rehab shortened to a booklet.

  • Get the diagnosis clear first

    Bronchiectasis, CF, COPD and breathing pattern disorder need different techniques. Guessing wastes months.

  • Choose a cardiorespiratory physio

    ACPRC-linked, hospital-trained cardiorespiratory physios - not general MSK physios doing chest work on the side.

  • Enough sessions to make it stick

    Airway clearance and breathing retraining need 6–12 sessions plus a home programme. One or two visits will not do it.

When it helps

When respiratory physio earns its place.

The diagnoses we see most, plus the red flag that means respiratory consultant urgently rather than a routine physio booking.

  • Bronchiectasis with daily sputum

    Daily airway clearance is the cornerstone of care - technique, device and frequency prescribed by a respiratory physio.

  • Cystic fibrosis

    Airway clearance, exercise and inhaled therapies - usually shared care with a specialist CF centre.

  • COPD with breathlessness

    Pulmonary rehabilitation improves breathlessness and quality of life more than any single inhaler change.

  • Breathing pattern disorder

    Hyperventilation, air hunger and unexplained breathlessness with normal lungs - retrainable in 6–8 sessions.

  • Post-COVID breathlessness and fatigue

    Structured, paced rehab and breathing retraining - with pacing tailored to post-exertional malaise if present.

  • Vocal cord dysfunction

    Rescue breathing techniques for inducible laryngeal obstruction - often mistaken for asthma.

  • Neuromuscular disease

    Cough augmentation, mechanical insufflation-exsufflation and lung volume recruitment for MND, DMD and post-polio.

  • Red flag: haemoptysis, rapid weight loss, night sweats

    Coughing blood, unintended weight loss or night sweats need urgent respiratory review - chest imaging first, then physio, not the other way around.

Procedure options

Technique depends on the diagnosis and the secretion burden.

What each option involves - from a free breathing pattern to a £12,000 oscillation vest - and when each earns its place.

  • Active cycle of breathing (ACBT)

    The workhorse technique - breathing control, thoracic expansion and huffing. Free, portable, and the foundation of most airway clearance regimes.

  • Autogenic drainage

    Controlled breathing at three lung volumes to mobilise mucus without coughing. Preferred in older children and adults with CF and bronchiectasis.

  • PEP therapy (Acapella, Aerobika, TheraPEP)

    Handheld positive-expiratory-pressure devices that oscillate airways and improve clearance. Prescribed, sized and technique-checked.

  • High-frequency chest wall oscillation (HFCWO)

    Inflatable vest that oscillates the chest wall - for adults and children with severe secretion burden. Rent or purchase, insurance-dependent.

  • Breathing pattern retraining

    Papworth method and Buteyko-informed retraining for breathing pattern disorder - diaphragmatic breathing, CO2 tolerance, biomechanics.

  • Pulmonary rehabilitation

    Structured 6–12 week exercise and education programme for COPD, ILD and post-COVID. The single most cost-effective respiratory intervention in adult medicine.

  • Cough augmentation

    Manual assisted cough, breath-stacking with an Ambu bag, and mechanical insufflation-exsufflation for neuromuscular disease.

  • Inhaler technique clinic

    A 20-minute session that fixes what 90 percent of GP inhaler prescriptions get wrong - spacer, pMDI, DPI, soft-mist.

Safety and recovery

What to expect from a programme - honestly.

Respiratory physiotherapy is a well-established discipline. The things worth planning are the diagnosis, the technique, the device and the escalation route.

  • Airway clearance is generally safe

    Standard airway clearance techniques carry minimal risk. Pneumothorax is rare and mostly seen in advanced emphysema or severe CF.

  • PEP and HFCWO have contraindications

    Undrained pneumothorax, active haemoptysis, unstable cardiovascular disease and rib fractures usually mean deferring or modifying.

  • Breathing retraining can feel worse briefly

    Slowing the breath and tolerating higher CO2 is uncomfortable early on. It settles within 2–3 sessions if the technique is right.

  • Post-COVID rehab must respect PEM

    Where post-exertional malaise is present, standard graded exercise is contraindicated - we use pacing and symptom-titrated activity instead.

  • Devices are prescribed, not bought online

    PEP devices, HFCWO vests and mechanical cough assist need a physio-led fit and technique check. Wrong device, no benefit.

  • Coordinate with respiratory medicine

    Inhaler changes, nebulised antibiotics and macrolides sit with the respiratory consultant. Physio and medicine are done in parallel, not sequentially.

  • Vaccination and infection precautions

    Flu, COVID and pneumococcal vaccination reduce exacerbations. Cross-infection precautions apply between CF patients as a matter of course.

  • Long-term self-management is the point

    The goal is a daily home programme you can run without us - not a permanent weekly clinic slot.

  • Red flags between sessions

    New chest pain, sudden increased breathlessness, fever with green sputum or haemoptysis need same-day GP, 111 or A&E, not the next scheduled session.

Reading your physio summary

Your physio summary in four parts. Read the last one first.

Whichever diagnosis brought you in - bronchiectasis, COPD, breathing pattern disorder or post-COVID - your summary keeps to the same shape.

A UK respiratory physiotherapist reviewing a patient’s spirometry results

A quiet reminder

Clinical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the notes and any results before your review, just ask.

  1. 01 Assessment

    Diagnosis and baseline

    Respiratory diagnosis, spirometry and questionnaire scores at first visit, and the primary problem being targeted.

  2. 02 Programme

    Techniques and devices prescribed

    Which airway clearance technique, which PEP or vest device, breathing pattern retraining protocol, and the home-programme schedule.

  3. 03 Progress

    Session-by-session outcomes

    Objective measures at reassessment - spirometry, six-minute walk, CAT, mMRC, Nijmegen - with a plain-English interpretation.

  4. 04 Impression

    Next step and self-management

    Read this first: current programme, discharge criteria, and any medical review recommended.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Respiratory physiotherapy is usually covered when linked to a diagnosed respiratory condition with a specialist referral. Pulmonary rehab programmes and HFCWO vests may need pre-authorisation.

Frequently asked

Everything we get asked about respiratory physio.

Quick answers on airway clearance, breathing retraining, pulmonary rehab, post-COVID and cost.

  • How is respiratory physio different from ordinary physio?

    Respiratory physios have cardiorespiratory sub-specialty training and use techniques - airway clearance, breathing pattern retraining, pulmonary rehab, cough augmentation - that general MSK physios do not learn in depth. Many are ACPRC members. For chest work, the sub-specialty matters.

  • How often do I need to do airway clearance?

    For bronchiectasis and CF, most guidelines recommend once or twice daily airway clearance when stable, and up to three times daily during exacerbations. The exact regimen - technique, duration, device - is set by your respiratory physio and adjusted at reassessment.

  • What is breathing pattern disorder and can it really be fixed in six sessions?

    Breathing pattern disorder is dysfunctional breathing - upper-chest, mouth-breathing, hyperventilation - that produces breathlessness, chest tightness and dizziness with normal lung function. A structured retraining programme (Papworth-informed) resolves or substantially improves most cases within 6–8 sessions.

  • Does pulmonary rehabilitation really help COPD?

    Yes - the evidence base is strong. Pulmonary rehab improves breathlessness, exercise capacity and quality of life more than any single inhaler change in most patients with symptomatic COPD, and reduces admissions. NICE and the British Thoracic Society both recommend it.

  • I had COVID a year ago and I am still breathless. Can physio help?

    Yes, often. A structured, individualised programme combining breathing pattern retraining and carefully paced exercise helps many people with post-COVID breathlessness. Where post-exertional malaise is present, we use pacing rather than standard graded exercise - this matters.

  • How much does private respiratory physio cost in the UK?

    Roughly £180–£280 for the initial assessment, £95–£150 for follow-ups, £950–£1,800 for an 8-week pulmonary rehab programme, and £620–£1,100 for a breathing pattern retraining course. HFCWO vests £2,800–£12,000 to purchase.

Related treatments

Looking for something else?