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The Guardian - UK
The Guardian - UK
Politics
Denis Campbell Health policy editor

Thousands with breathing problems undiagnosed due to lack of tests in England

A person using an inhaler.
Asthma and Lung UK says its report ‘shines a light on the dire state of lung healthcare in England’. Photograph: Clive Gee/PA

Thousands of people with asthma and other lung problems are going undiagnosed because most GPs in England do not offer tests for them, according to a new report.

The failure to diagnose and start treating people with breathing problems threatens to create “a deluge of hospital admissions this winter” when the NHS is under intense pressure.

Sarah Woolnough, the chief executive of charity Asthma and Lung UK, said: “The abysmal lack of testing and patchy basic care is causing avoidable harm to people with lung conditions and the NHS.”

The report, which the Charity Commissioned from consultants PricewaterhouseCoopers, found that most GP surgeries in England do not provide basic lung function tests.

Despite lung diseases being Britain’s third-biggest killer, after cancer and heart conditions, the tests are not included in the contract that family doctors have with the Department of Health and Social Care, which specifies what services they must provide and will be paid for.

Patients’ inability to access a test to check if they have asthma or chronic obstructive pulmonary disease (COPD) represents a “crisis in care” that could lead to many being hospitalised this winter “as respiratory viruses take hold and people struggle to heat their homes”, Asthma and Lung UK added.

The report “shines a light on the dire state of lung healthcare in England, often leaving people with breathing difficulties without a confirmed and accurate diagnosis, or receiving treatment for conditions they don’t have”, the charity said.

Lung problems cost the NHS in England an estimated £9.6bn a year, and lost productivity due to illness and death costing a further £4.2bn, PwC found.

However, better testing could save the NHS £2.2bn, with fewer people suffering flare-ups resulting in time spent in hospital, PwC concluded.

“Early detection is crucial for treating and managing lung conditions effectively and can help slow down the progression of incurable lung diseases such as COPD, which includes emphysema, or protect people from potentially life-threatening asthma attacks”, said Asthma and Lung UK.

People with lung problems end up “trapped in a vicious circle of late diagnosis, a limited number and lack of access to treatments, and poor support, leaving people to fend for themselves. This leads to avoidable emergency hospital admissions, causing pain for people with lung conditions and their families and putting a significant, avoidable strain on the NHS”, it added.

The charity highlighted that GPs are contracted to offer tests for other major killer conditions, including heart failure, but not for breathing problems. Improved testing and care could save the NHS almost 273,000 hospital bed days a year, it added.

“In many areas of the country basic lung function tests are not easy to access. The barriers GP practices face are huge,” said Dr Andrew Whittamore, the charity’s clinical lead.

“These include lack of funding, workforce and training needed to carry out these tests properly and the physical space needed to do them.”

NHS England has been for comment.

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