What are the referral criteria for a patient with interstitial lung disease to a specialist respiratory service?

Refer patients with interstitial lung disease (ILD) to secondary care for specialist management, including assessment and diagnosis, when clinical features, lung function, and radiological findings are inconclusive or suggest the need for further investigation ¹.

Referral is indicated if a confident diagnosis cannot be made from clinical features, lung function, and radiological findings, and consideration of bronchoalveolar lavage, transbronchial biopsy, or surgical lung biopsy is required, with the patient's informed discussion of benefits and risks ¹.

Patients should be referred to a multidisciplinary team with expertise in interstitial lung disease, which includes a consultant respiratory physician, radiologist, histopathologist, and ILD specialist nurse, especially when considering invasive diagnostic procedures ¹.

Referral is also appropriate if there is a need for specialist assessment of prognosis, management options, or support, including information and support for patients and families ¹.