Patients waiting up to 3 years for pulmonary function tests

The HSE needs to urgently address delays in the provision of pulmonary function tests (PFTs), which are crucial in the diagnosis of a number of lung diseases, such as asthma and COPD, the Irish Lung Health Alliance has said.

The alliance, which is made up of a coalition of charities that work to promote healthy lungs, surveyed 19 pulmonary function laboratories and found that many patients are having to wait months, and even years, for PFTs as a result of widespread staff shortages.

The survey found that among the 19 laboratories, 68% had vacancies for respiratory physiologists, with most having multiple vacancies.

When it came to PFTs, nine of the laboratories had waiting lists of at least 18 months, while four had waiting lists of at least three years.

When it came to sleep studies, which are used to diagnose conditions such as sleep apnoea, nine laboratories had a waiting list of at least one year, while six had a waiting list of at least two years.

Sixteen of the 19 laboratories pointed out that their workload had increased since before the Covid pandemic, with two stating that their workload had increased by 100%.

According to Irish Lung Health Alliance member and consultant respiratory physician, Dr Marcus Butler, the covid pandemic has exposed how under-resourced the PFT service is.

“PFTs are crucial in making an accurate diagnosis of conditions such as COPD and to determine the severity of practically every other lung disease. This is a test that should be available as quickly as possible based on often urgent clinical need – for urgent cases, ideally on the same day. 

“At the moment, we are being left to make an educated best guess, which is like seeing a diabetes patient without knowing their blood sugar levels. We really are working blindfolded,” Dr Butler noted.

He pointed out that latest figures from the Central Statistics Office show that of the 33,055 people who died in 2021, almost a quarter of these died as a result of a lung-related illness, including Covid-19.

“Yet, there are lung function tools available that can help us to reduce lung health mortality and morbidity, but we need to have access to them. Our health service can, and must, do better,” Dr Butler insisted.

Also speaking about PFTs, senior respiratory physiologist and President of the Irish Institute of Clinical Measurement Physiologists, Ann Marie O’Connell, noted that these tests are not only vital in the diagnosis of lung conditions, they are also key to the ongoing treatment of patients who may be undergoing surgery, chemotherapy and bone marrow transplants.

“Unfortunately, too many laboratories that carry out these tests are now seeing waiting times of anywhere between 18 months and three years and indeed longer.

“The precautions required for Covid have meant that we are seeing a lot less patients each day due to hygiene requirements. It has played havoc with the scheduling of appointments and has meant our waiting lists getting longer and waiting times being pushed further out,” she explained.

She said that additional training places for respiratory physiologists need to be put in place urgently so that waiting lists can be reduced.

“Additionally, we need to ensure greater consistency among hospitals when it comes to the availability of hygiene equipment and facilities, whether that be air sterilisers, HEPA-filtration, screens or negative pressure rooms,” Ms O’Connell added.

The survey of laboratories took place in August 2022. The Irish Lung Health Alliance highlighted this issue ahead of World Lung Day (September 25).