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Practice comment

The government's health checks must include respiratory disease

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The British Lung Foundation is calling for all at-risk over 35s to be given spirometry testing, but more training is needed to deliver this, warns Dame Helena Shovelton

The NHS should transform itself from being a curative service to being a preventative one as well: this was the vision set out by health secretary Alan Johnson when he announced a programme of health checks for heart disease, stroke and diabetes for over-40s in England earlier this year.

Although this was a positive step forward for the NHS, the British Lung Foundation (BLF) was disappointed that this programme failed to address the UK’s second biggest killer and the most common cause of emergency hospital admissions: respiratory disease.

The BLF is determined that this situation should change and is calling for all at-risk adults over 35 to be given a spirometry test, particularly if they present with symptoms such as a persistent cough or excess phlegm, or if they are current or ex-smokers. This will mean that lung conditions such as COPD can be detected earlier and treated.

COPD is a major concern for the BLF. It is estimated that more than 3.7 million people in the UK are affected, yet less than one million are currently diagnosed. If left untreated, COPD can severely restrict patients’ lives, leaving them unable to work and struggling to carry out everyday activities. Without proper treatment and care they find themselves being rushed to hospital time and time again – a terrifying event for the patient and costly for the NHS.

COPD is largely an invisible disease because most people in the UK have never heard of the condition or its symptoms. It has been neglected by healthcare services and is frequently misdiagnosed. This has led the BLF to highlight the need for healthcare professionals in primary care to be offered improved training so they feel confident to carry out spirometry testing, to interpret the results and provide newly diagnosed patients with advice, treatment and help to self-manage.

To tackle this lack of awareness, the BLF published a report on the eve of World COPD Day in November 2007. This highlighted the UK’s COPD ‘hotspots’, where people are most at risk of being hospitalised with the condition (BLF, 2007).

From this analysis, the foundation selected a list of COPD hotspot areas by primary care organisation. By identifying these high-risk populations at postcode level, the BLF is now starting to move into targeted health campaigning to bring about improved awareness, diagnosis, treatment and care of people with COPD.

The first of these campaigns took place in the top COPD hotspot in the UK, South Tyneside, at the start of this year. The campaign, Love Your Lungs, was organised with South Tyneside PCT. The results showed the success of this targeted approach. Over 600 people were tested at four lung-testing events in bingo halls and supermarkets and, of these, almost one-quarter (23%) were referred to their GP – a remarkably high percentage.

In addition to these events, the BLF called over 5,000 people in at-risk postcode areas about the campaign. The response was overwhelmingly positive, with almost 70% wanting more information or a call from the BLF helpline.

We are doing what we can to make sure that everyone at risk of lung conditions such as COPD understands what it is and gets treatment and support before the disease limits their lives. We are now urging healthcare professionals in primary care, policymakers and health and social care planners to do the same by working with us to tackle this devastating disease.


Dame Helena Shovelton is chief executive, British Lung Foundation


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