Creating a new NHS England: Health Education England, NHS Digital and NHS England have merged. Learn more.
Tackling a disease that won’t go away
NHS England’s National Clinical Director for Respiratory Services looks at improving our approach to the deadly effects smoking can have:
NHS RightCare today launches its latest pathway aimed at addressing Chronic Obstructive Pulmonary Disease (COPD).
It sets out to health commissioners and providers how to ensure early detection with accurate diagnosis and optimise long-term management to reduce exacerbations, hospital admissions and premature mortality.
The pathway has been developed by NHS England in collaboration with the British Lung Foundation, the British Thoracic Society, Respiratory Futures, the Primary Care Respiratory Society (PCRS-UK), and the National COPD Audit Programme.
As NHS England’s National Clinical Director for Respiratory Services, I explore the impact of COPD, how treatments have developed and what more can be done to improve the outcomes for people with this condition.
Many people view COPD as a self-inflicted, untreatable, progressive condition that will pass in to history as smoking rates decline. In fact, this is far from the truth as we learn more about this complex condition.
Current figures show:
- 2 million people in the UK have diagnosed COPD.
- Up to three times as many people have not yet been diagnosed.
- Almost 30,000 people die from COPD annually.
- Over 1 million bed days per year are taken up by COPD patients.
Not everybody who smokes will develop COPD and non-smoking causes of COPD are becoming more evident. The epidemiological evidence suggests that future emergency admissions to hospital will rise rather than decline as the population ages and treatments improve.
These days, treatment options for COPD have multiplied and include improved inhalers, rehabilitation and even surgical options for emphysema. Emergency treatment has been revolutionised with the introduction of acute non-invasive ventilation.
The organisation and delivery of care has also improved with the development of integrated care models and self-management strategies for admission avoidance. Despite this, early and accurate diagnosis remains poor and there is a four-fold variation in hospital admission rate that cannot be explained by case mix.
While this complex landscape may tax providers and health professionals, it also generates a challenge to commissioners who will need to be more aware of the requirement for an integrated approach to commissioning.
The NHS RightCare pathway provides a template for best commissioning practice. There are clear advantages to Clinical Commissioning Groups (CCGs) and Sustainability and Transformation Partnerships (STPs) that take a population approach by commissioning the whole clinical pathway and adopt risk stratification to ensure that patients are treated in the most suitable location by the appropriate health professional.
If these steps were taken CCGs could annually achieve:
- 1,400 fewer unexpected deaths.
- A £49million cost saving.
- Earlier detection of 210,000 patients.
Accurate diagnosis and high value treatments including smoking cessation and pulmonary rehabilitation are known and should be prioritised over those that are known to be less effective. If this approach is taken, then CCGs can expect reductions in avoidable mortality, hospital admissions and reduced cost.
There is no cure for COPD but the condition can be detected much earlier and managed more effectively with simple steps and a change in attitude.
- For those not familiar with NHS RightCare, it is a national, NHS England programme committed to delivering the best care to patients, making the NHS’s money go as far as possible and improving patient outcomes.
- You can see an overview of our work, projects and resources on the RightCare website.
Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, and refractory (non-reversible) asthma. This disease is characterized by increasing breathlessness. COPD is the third-leading cause of death in the United States, preceded by only heart disease and cancer. It predominantly occurs in people over 40 years of age and affects more than 11 million Americans. For more information Visit Here.
Share more information with us…Thanks for sharing this blog…Keep sharing
COPD, according to 2015 data from the World Health Organization (WHO), is the fourth leading cause of death in the world. In US, more than 16 million people have been diagnosed with COPD, although more than half are not diagnosed. That is why it is said to be a very frequent disease, but unknown. In this article, we explain the causes of COPD, its symptoms, diagnosis and treatment.
I am troubled by lack of purpose. Eg to have a correct diagnosis in prim care. Patients in the community to have ready access to expert care. Wasteful prescribing to stop and.savings to be recycled into treatments with value (right care). Readmissions to be less that 15% within 30 days. Deaths in hospital from copd to be reduced.No exemptions from spirometry in primary care.
How might this be achieved ie the plan?
Commission care as whole pathways
Hospitals to have a role in the community to prevent admission and also train up Gp nurse/ practice leads. Annual audit of each community results.
Buurtzorg, Chronic Care Model and NZ but three examples
I have COPD stage 3. only recently diagnosed. I am trying to give up smoking and have cut down considerably using nicotine patch’s. But my GP won’t prescribe them for me. I don’t know why but I thought GP’s are supposed to help with stopping smoking. I’m on benefits and I can’t afford the path’s and I’m terrified of failing. I tried the smoking cessation but they want you to give up totally within a week or you’ve failed and then they won’t help you any more!! I can’t go ‘cold ‘turkey’ like that. So where are you supposed to get help from then??
Mike Morgan is far too busy to reply, it seems.