Asthma + Lung UK New Report

This new report into the provision of key respiratory diagnostic tests such as spirometry and FeNO testing investigates ways to improve early and accurate diagnosis.  

It aims to make the case for healthcare professionals and commissioners at ICB level for the need to ensure the timely and accurate diagnosis of respiratory conditions, and why expanding access to these crucial diagnostic tests should be prioritised, despite the difficult financial situation. It includes clear and accessible examples of how this can be achieved in practice, with a range of transferable best practice case studies.  

The report shows:  

• Accurate and timely diagnosis of respiratory disease requires primary care pathways that ensure prompt access to diagnostic tests
• Early and accurate diagnosis of respiratory conditions should be prioritised. This will require funding solutions such as commissioning or other incentives
• How the establishment of ICSs provides greater scope for local planning to meet the needs of local populations
• Why community diagnostic centres (CDCs) are intended to add capacity, not replace it from primary care. Our report argues that action is still needed elsewhere in primary care and services should not rely on CDCs to meet diagnostic demand in their area.

What Asthma + Lung UK are calling for
The report makes the following key policy recommendations for action at integrated care system (ICS) and national level:  

• Prioritise respiratory health at ICS level: Integrated Care Boards (ICBs) should develop business cases for respiratory diagnostics.
• Workforce planning and training: ICBs should ensure that there is an appropriately qualified workforce in place, by prioritising delivery of training. 
• Funding spirometry: specific NHS England funding is needed to improve spirometry training at primary care level. Funding should be made available via GP or PCN contracts, or any other suitable mechanisms. ICBs need greater flexibility to allocate funding where it is most needed.  
• The role of CDCs: NHS England should provide clear guidance that CDCs should not be relied upon as the sole provider of respiratory diagnostic tests. 

Swift introduction of the new pre-diagnosis breathlessness pathway for adults: we need to see evaluation and wider promotion and roll-out of this pathway within ICSs within the next 12 months.