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Experts call for greater use of breath test in GP practices

Five-year plan for better lung health launched

Adrian O'Dowd

Thursday, 06 December 2018


GPs should make far greater use of the spirometry test to help identify more people living with lung disease, according to experts.

The Taskforce for Lung Health – a 29-member strong collaboration between patient representatives, health care professionals and other experts organised by the British Lung Foundation – has called for the inexpensive breath test to be much more widely used in GP practices, community health services and hospitals to improve diagnosis of lung disease.

A fifth of people live with lung disease and respiratory conditions are responsible for a large part of the gap in life expectancy between the poorest and wealthiest in the population.

The taskforce has developed and now published a new national five-year plan* to improve lung health in England that sets targets to improve early diagnosis, including:

  • 93% of patients who need to be referred to a specialist should be referred within two weeks
  • 96% of patients should start treatment, where possible, within 31 days of a diagnosis and with a package of care agreed.
Lung disease is the third biggest killer in the UK, but there is no clear route to be followed by GPs, community pharmacists, nurses and other health care professionals when a patient presents with severe breathlessness or other symptoms.
 
The taskforce said there were also no time targets for how quickly they should be seen and receive the diagnostic tests and start treatment, unlike for other serious illnesses such as cancer.

Spirometry tests were currently underutilised in GP practices and diagnostic hubs within hospitals, they argued. Patients were not being tested because the equipment was not to hand, or health professionals were not trained to use it or they did not have the necessary time to undertake the test.

That needed to change if people were to have the best chance of an accurate diagnosis and access to treatments early enough to get the best results.

For the sake of a short training course for health professionals and at a cost of less than a £1,000 a year for a specialist device, millions of patients could have an accurate diagnosis, they said.

The spirometry test took about 10 minutes and was used to tell if breathing was obstructed by narrowed or inflamed airways. The taskforce said it wanted the test to be used routinely in diagnosing lung conditions such as COPD and asthma, in people whose medical history and symptoms indicated lung disease.

Dr Penny Wood, chair of the taskforce, said: “Early diagnosis for lung disease is crucial. That’s why it’s so important that patients are able to have a spirometry test when suffering from breathlessness and other symptoms. If we can catch it early, they won’t get lost in the system.

“Unlike other major disease areas, lung disease is lagging in both public awareness and mortality rates, and treatment varies across the country. But up until now, patients haven’t had a voice. The taskforce plans to change this by transforming the care for people living with lung conditions.”

Dr Steve Holmes from the Royal College of GPs said: “Spirometry tests are extremely effective, but we need to see GP practices supported to fund the one-off cost and subsequent training sessions needed for practice staff to use them and interpret the results.

“A relatively small amount of funding has the potential to save lives. We also need to see public campaigns about lung disease, so that patients are more aware of potential symptoms and can seek medical assistance at an earlier stage in their condition.”

*A National Five Year Plan for Lung Health. Prepared by the Taskforce for Lung Health, December 2018.

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