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COPD is not a Cinderella disease

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VOL: 97, ISSUE: 12, PAGE NO: 1

Claire Kent, RN, DipNurs, is respiratory sister, Queen Elizabeth Hospital, King’s Lynn, Norfolk

For those of us who work in respiratory care the initials COPD (chronic obstructive pulmonary disease) are part of the fabric of our daily working lives. Yet in the world beyond health care most people have never heard of COPD. When did you last open a newspaper and read an article about it?

For those of us who work in respiratory care the initials COPD (chronic obstructive pulmonary disease) are part of the fabric of our daily working lives. Yet in the world beyond health care most people have never heard of COPD. When did you last open a newspaper and read an article about it?

COPD is a disease that affects the older half of the population and is undoubtedly linked to smoking. It creeps up insidiously. Patients often put up with decreasing lung function as part of the ageing process for so long that they do not present until that lung function is drastically reduced.

Leaving aside the smoking-related issue, there has to be something in the chronic nature of COPD that, in the pecking order of health care provision, makes it seem so unimportant.

Treatment offered cannot be curative, but the excellent examples of palliative care widely available to those with malignancy are not generally reflected in the services offered to patients with chronic respiratory disease. In fundraising terms, COPD has neither the glamour nor the kudos of cancer.

I am demoralised by the never-ending battle to raise the profile of chronic respiratory disease. Take pulmonary rehabilitation - a well-proven package, offering validated benefits to clients, yet still available only in a minority of centres. There is widespread acceptance, and indeed government rhetoric, that we should work towards the ending of care determined by postcode. But what about the availability of care being determined by disease process?

It has become second nature to acquire funding on the back of other initiatives. How many of us in respiratory care have tried to improve services as part of a lung cancer initiative? The recent increase in the number of lung cancer nursing posts is not necessarily the investment that would help the greatest number of patients - it simply enables trusts to meet national cancer standards. It is ironic that this had to be seen as a golden opportunity to acquire some funding on the back of something else. But at least it is funding we had a realistic chance of acquiring. In the campaign to reduce waiting lists and increase day case surgery we were never going to get a look-in.

So what would I wish for? A national service framework for respiratory disease could be a useful starting point. But this has to include chronic respiratory disease. COPD is not a Cinderella diagnosis - people’s lives are affected by it daily for years, and it is time they were given some recognition and not seen as second-class citizens in the realm of health care.

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