Diagnosis: a review of 2021

A reflection on 2021 and the developments around improving the early and accurate diagnosis of lung disease, from the Co-chairs of the Taskforce for Lung Health Diagnosis working group.

  • Carol Stonham, Senior Nurse Practitioner, at Primary Care Respiratory Society

  • Dr Steve Holmes, General Practitioner at Royal College of General Practitioners

The COVID-19 pandemic has continued to have a significant impact on the early identification of lung disease. A paper prepared by the Department of Health and Social Care (DHSC) and Office for National Statistics (ONS) on health impacts of COVID-19 found that diagnoses of COPD fell by 51% between 2019 and 2020.  In addition, the capacity to diagnose patients with lung conditions using the necessary objectives tests remained low throughout 2021, with the ongoing delay in restarting spirometry in primary care having a severe impact.

This means the need has never been greater for a step change in the way respiratory patients get a timely and accurate diagnosis.  Fortunately, this year has seen two significant and exciting developments which we believe hold considerable potential to improve lives. The first is the imminent introduction of an NHS pathway for diagnosing breathlessness, and we are delighted that it aligns with the principles of the Taskforce’s own diagnosis pathway developed in 2020.

The second is the announcement that a network of community diagnostic centres will be established across the country. We await details of how frontline clinicians will be supported to adopt the pathway in a timely, consistent and effective way, as well as the specifics about where, when and how the centres will operate. Taskforce is particularly interested in how these changes will look and feel for patients, and how best practice is shared across the country. We intend to monitor this closely.

Looking ahead to 2022, we’re hoping there will be positive progress across a number of other areas of  Taskforce’s work on diagnosis, including our call to roll-out the use of CT-scans as a first-line test for diagnosing certain lung conditions, targeted case finding of people with COPD, expansion of the lung health checks programme and the delivery of a national screening programme.

Our Taskforce commissioned research into patients’ experiences of the time elapsed during their journey to receiving a diagnosis will also be published and we will use this to help shape our future influencing work.

Read our three years on report here

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20 January 2022