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Respiratory strategy needs detail

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A strategy to improve the health of people with respiratory conditions has been criticised for lacking detail on the role of nurses, despite being more than six years in development.

The Department of Health’s Outcomes Strategy for Chronic Obstructive Pulmonary Disease (COPD) and Asthma in England aims to give respiratory disorders a higher priority.

It’s a very high-level, overarching strategy but without any actual detail for clinicians on the ground

However, some nurses and other health professionals said they did not know how they would be held to account for meeting the strategy’s six objectives, which include more early diagnoses, better self management and a reduction in health inequalities.

The 56-page strategy is a quarter of the length of the consultation document released at the start of 2010.

Association of Respiratory Nurse Specialists committee member Carol Kelly said the strategy could turn out to be a disappointment because there were no incentives for commissioners to invest in respiratory services.

Respiratory nurse consultant Gail South, who runs Breathing Space in Rotherham, a nurse-led community respiratory unit, said: “It’s a very high-level, overarching strategy but without any actual detail for clinicians on the ground, or detail on who is going to audit what we are doing.”

Ms South said the lack of detail meant that local areas could follow different paths, worsening health inequalities.

The strategy highlights the link between mental health and respiratory health. This exists partly because people with mental health problems are more likely to smoke, and also because the limitations of COPD can lead to anxiety and depression.

It also introduces the acronym REACT to help professionals understand the elements of good care. It stands for respiratory health, early diagnosis and assessment, active partnerships between patients and professionals, chronic disease management, and tailored, evidence-based treatment.

Respiratory nurse consultant Jane Scullion, one of 32 respiratory leads working for strategic health authorities, told Nursing Times that, while details still needed to be worked out, the strategy would help make the case for specialist respiratory nurses.

A DH spokeswoman said the strategy was a “high level document” and more details would follow in the autumn.

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