Patients in some of the most deprived areas of England, where respiratory conditions including chronic lung disease (COPD) and asthma are most prevalent, have limited or no access to vital diagnostic tests to confirm their diagnosis, reveals a survey by The BMJ.
Despite NHS England’s promise of access via Community Diagnostic Centres (CDCs), GPs in some of the worst affected areas say having no means of referring patients for lung function tests is ‘troubling’ and ‘a silent scandal.’
And last month, a report by the charity Asthma + Lung UK warned that without timely and accurate diagnosis, people with lung conditions do not get treatment for their symptoms, suffer acute and long term deterioration, and die early.
Lung conditions are the third biggest killer in the UK. The government’s Major Conditions Strategy highlights the need for early and accurate diagnoses of lung conditions.
NICE also states that spirometry should be performed for diagnosis of COPD and asthma, but there are no central data on spirometry provision.
In a survey of England’s 42 integrated care boards (ICBs)the BMJ found that provision was patchy, with some ICBs admitting that they no longer commissioned spirometry.
The BMJ also found disparities of access to diagnostic services between more and less deprived areas within ICBs. For example, availability is poor in Rotherham and Doncaster, two regions with high historic levels of diagnosis of COPD due to large communities of former miners, but better in the home counties and Nottinghamshire.
Asthma + Lung UK it was crucial for NHS England to provide funding for quality-assured spirometry at a primary care level, incentivising spirometry as a paid-for diagnostic test within the GP contract.
