A leading lung specialist will today tell a major conference that Wales, the first UK country to have a national respiratory health plan, is making ‘good progress’ – including the completion of a comprehensive national training programme for health professionals in using a vital breathing test (a spirometer) - essential to achieving earlier and accurate diagnosis of chronic lung disease.
The reduction in smoking rates across Wales will also be highlighted.
Dr. Ian Ketchell, Consultant Physician in Respiratory and General Medicine at Cardiff and Vale University Health Board, is presenting an update report on ‘what’s working’ in Wales to improve lung health - at the British Thoracic Society (BTS) Winter Meeting (Wednesday 5th December 2018).
He will tell delegates that education and training of health professionals has been key to the national effort to diagnose lung disease earlier and more accurately. Previous research across Wales had found that around 25% of chronic obstructive lung disease (COPD) diagnoses may not have been correct – mostly due to poor quality spirometry.
In response, standard spirometers have been provided throughout primary care in Wales, which by the end of 2018 will be fully integrated with the Welsh Clinical Portal (a single digital portal) to capture results and patient information. Also, health professionals across Wales have received quality-assured training in using the equipment and interpreting the results.
Respiratory health is a major issue in Wales:
- 1 in 12 people has a respiratory illness
- 1 in 7 deaths were due to respiratory disease
- The country has the highest prevalence of asthma in Europe
This backdrop provided the impetus for concerted national action. The ‘Wales Respiratory Health Delivery Plan’, launched in 2014, aims to improve lung health across Wales by reducing variations in treatment and sharing best practice in different disease and programme areas. It was revised in January 2018 and extended to 2020 and is delivered across the whole of the NHS in Wales. It includes perspectives from primary and secondary care as well as NHS managers, Welsh government, the third sector and respiratory patients.
Dr. Ketchell will explain that a number of key actions in the Plan have empowered many more patients to tackle their different lung problems:
- Smoking rates are falling in line with the rest of the UK, which has been helped by the creation of hospital-based smoking cessation specialists with increased provision of in-hospital stop smoking support.
A new system is also being developed to allow patients who want to quit the choice of the support they want, for example via the pharmacy or from one-to-one or group counselling sessions. Cardiff and Vale University Health Board now has the lowest prevalence of adult smokers at 15%.
- An integrated health and leisure programme has been delivered, with training and accreditation for local providers throughout Wales - varying from allotment gardening, pulmonary rehabilitation or gym activities through to a National Exercise Referral Scheme.
- The Welsh Difficult Asthma Group (WeDAG) has been formed to meet monthly and review those patients whose asthma is most severe or difficult to control. These patients are reviewed in a hospital setting and each hospital/health board in Wales now has a consultant with specialist interest in asthma who is part of the group.
Other key results from the plan include:
- The Tuberculosis (TB) review, set up in 2012, has resulted in a steady increase in patients completing treatment – with an increase of HIV testing from 54% in 2012 to 96% in 2016.
- The delivery of the first national prescribing pathway anywhere in the world, to ensure consistent respiratory care.
- Creation of a dedicated online TV channel, www.icst.tv, to provide over 60 interactive respiratory e-learning courses for health professionals - addressing major diseases and issues in respiratory care and featuring many local and international experts.
Dr. Ketchell will tell delegates that a key focus has been on prevention of lung disease:
“Respiratory disease was costing the NHS in Wales £400 million a year and so prevention has been at the heart of the plan. We now have a strong system of sharing best practice on key ways to help prevent lung disease - such as increasing the number of people getting NHS support to help them quit smoking and increasing the vaccination rate for ‘flu and pneumonia.
We have been making good progress in combatting lung disease on many fronts in Wales – prevention, diagnosis, treatment and care. The results of key parts of the strategy are really coming through now. And we are particularly pleased in the reduction in tobacco use across Wales, as this is the single most effective way to prevent many lung diseases or help treat them.
There is, as ever, a lot more we need to achieve in reducing health inequalities and variations in treatment and outcomes for lung disease – but we feel that we have put the foundations in place to make real progress in the future.”
For more information prior to the British Thoracic Society Winter Meeting (i.e. before Wednesday 5th December 2018):
Charlotte Sutton t: 07958 279240
Alessandra McKenna t: 07967 976652
Ed Gyde t: 0780 9574801
During the British Thoracic Society meeting (from Wednesday 5th to Friday 7th December 2018):
Please contact the BTS news media office on t: 020 7798 4543 / 020 7798 4541 or the mobile numbers above.
Note to Editors:
The ‘Wales Respiratory Health Delivery Plan’ and the role/core activities of the Respiratory Health Implementation Group (RHIG)
The Respiratory Health Implementation Group (RHIG), responsible for implementing the plan, is focusing on the following core areas:
To reduce variations in treatment, new guidelines are in development – to be completed by 2020 – with all work streams stating what they have done and hope to achieve, leading to consistent care and based on best practice. An integrated, digitalised Quality Improvement platform has been developed to use data to change practice.
Education and communication
A further major initiative to support consistency of care is healthcare professional education with mechanics to reach everyone delivering respiratory care in Wales. This has been achieved through documents, video messages, development of a clinical pathways App, and an online TV channel, icst.tv, which can also be accessed through a mobile app.
Data and IT
The Respiratory Health Delivery Plan is also now implementing a fully integrated IT system which allows health professionals to access patient information across Wales – 93% of primary care data is now uploaded compared to 0% in England. This data helps drives simple and scalable changes to improve the way care is delivered. The system will act as the framework for national disease databases, host national guidelines and educational tools and allow data sharing with patients through the patient portal.
British Thoracic Society
The British Thoracic Society is the UK’s professional body of respiratory specialists. The Society seeks to improve standards of care for people who have respiratory diseases and to support and develop those who provide that care. A registered charity, it has around 3,500 members including doctors, nurses, respiratory physiotherapists, scientists and other professionals with a respiratory interest.
The British Thoracic Society Winter Meeting takes place between 5-7 December 2018 at the Queen Elizabeth II Conference Centre in Westminster, London.