2019 was a year of progress
Professor Mike Morgan was the National Clinical Director for Respiratory in England until October 2019 and is a firm supporter of the Taskforce for Lung Health and its work.
When I first became Clinical Director more than six years ago, respiratory disease had no priority in the commissioning system, no formal clinical network and consequently no support team within NHS England. This was despite the fact that UK has one of the highest death rates for respiratory disease in Europe.
The biggest injustice is that most deaths are in deprived areas and the mortality gap between rich and poor is growing. Respiratory admissions to hospital double in the winter months and are largely responsible for the winter surge.
The importance of lung health is now recognised
The Taskforce for Lung Health has become an important catalyst for change. It brings together patients, clinicians, charities and industry. Thanks to the Taskforce, and the stewardship of the British Lung Foundation, the patient voice is loud and clear in NHS England’s Long Term Plan.
For the first time the importance of lung health is recognised with the launch of the Respiratory Programme within the Long Term Plan, which is a remarkable achievement.
NHS England now acknowledges the human cost of lung disease and change is underway. In retrospect, it is hard to see where the turning point occurred but the arguments for supporting a respiratory programme gradually became stronger. Our NHS is simple in concept but below the surface it is a complex organisation that is difficult to navigate, so searching out opportunities and making alliances is a vital skill.
Early wins included a joint national strategy for TB with Public Health England, a Best Practice Tariff for COPD and a successful bid for a National Asthma Audit with Asthma UK. In 2018 NHS England began the Respiratory Programme and this priority was subsequently confirmed in the Long Term Plan.
Specialists need to adapt
The world is changing and the force for improving outcomes in respiratory disease lies outside hospitals. Specialists of the future will need to adapt to take their skills out of hospital and integrate with primary care to improve the diagnosis and management of common respiratory conditions. They also need to think more about the characteristics of the population they work with and help the most deprived in society.
The respiratory community now has the responsibility to deliver the programme.