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Comment - It's time for a national service framework

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Eileen Shepherd

DipN, Editor, Respiratory Nursing

The British Thoracic Society has described lung disease as a burden, and anyone working in respiratory care knows what a huge burden it is to patients, for whom there is frequently no cure. Many also face unemployment and social isolation as well as dependence on oxygen therapy and, eventually, terminal care.

The British Thoracic Society has described lung disease as a burden, and anyone working in respiratory care knows what a huge burden it is to patients, for whom there is frequently no cure. Many also face unemployment and social isolation as well as dependence on oxygen therapy and, eventually, terminal care.

The health services have the financial burden of caring for a group of patients who are repeatedly admitted to hospital with exacerbations of their condition - many of which could be prevented or at least anticipated.

A recent report from Dr Foster Intelligence, Keeping People out of Hospital: The Challenge of Reducing Emergency Admissions, identified COPD as the most common reason for readmission to hospital. The report has projected an increase in emergency admissions for COPD from 108,256 last year to over 159,000 in 2028 at a cost of £376 million. Government policy is focused on improving the care of people with long-term conditions such as COPD, and this is reflected most recently in the white paper, Our Health, Our Care, Our Say and Department of Health guidance, Supporting People with Long-term Conditions to Self Care.

Community matrons and respiratory nurse specialist are making progress in improving the care of people with chronic lung disease in their own homes, and in the past few months British Lung Foundation nurses have started work in a number of primary care organisations (see Update, p40). An expressed aim of the scheme is to reduce readmission rates as well as provide palliative care services.

While all these improvements are welcome, we have to acknowledge that the only way to prevent smoking-related lung disease is through health education. Guidance from NICE on smoking-cessation that was published in March has a clear message that this has to be a responsibility for every healthcare professional.

At last it seems as though policy-makers are beginning to address the needs of people with long-term conditions. However, what patients with chronic lung disease need, together with the health professionals involved in their care, is a national service framework. Only then will the specific needs of this vulnerable group of patients be able to be addressed.

 Dr Foster Intelligence: www.drfoster.co.uk.

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