World COPD Day

Thursday 20th November 2025 Westminster Hall

[Clive Efford in the Chair]

15:00

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered World COPD Day.

It is a pleasure to serve under your chairship, Mr Efford. I thank the Backbench Business Committee for making time for this debate. I am always pleased to see the Minister in her place—she knows that—and we look forward to her answers to our requests on behalf of our constituents. I am also pleased to have other colleagues here, including the shadow Ministers for the Conservatives and for the Lib Dems, the hon. Members for Farnham and Bordon (Gregory Stafford) and for North Shropshire (Helen Morgan), and also my good friend, the hon. Member for Surrey Heath (Dr Pinkerton).

I am glad to be able to raise the issue of chronic obstructive pulmonary disease. Yesterday was World COPD Day, so I pay tribute to the wonderful work carried out by so many organisations and individuals to draw attention to the illness. We had an event here last night, which was well attended. The people in the Gallery are those who do the hard work for the all-party parliamentary group for respiratory health, which I chair. We had a great event last night with many excellent speakers.

I want to reflect on the organisations and individuals that attended last night to draw attention to the illness. Hugh McKinney is going to look at me and say, “You mentioned that lady again”, because last night one of our special guests was Shirley Ballas of “Strictly Come Dancing”. I could not dance if my life depended on it—I have two left feet—but that lady can. Last night she was not there because she is a judge on “Strictly Come Dancing”. She was there to tell the story of how she cares for and looks after her mum, who has COPD. There are two sides to the lady—the side we see on TV and the caring side. The previous debate was about unpaid carers across the United Kingdom, in all constituencies, and the work that they do. It was a pleasure to take part in that debate and to see so many there.

As chair of the APPG for respiratory health, I will cover a number of issues today around COPD. I will frame my comments around the latest initiatives and also the current policy direction. Hopefully we can try to marry those two together so that we can have a focus and a target to do better. To make that happen, of course, we need Government and ministerial support.

As always, I am indebted to Sarah Sleet and her wonderful team at Asthma and Lung UK for their outstanding help and ongoing support. Without their enormous help to me and the APPG that I chair, we just could not manage as well as we do. I also want to say a special thanks to Jonathan Fuld, the national clinical director for respiratory disease, for his expert advice and counsel. I pay tribute to the ongoing work of our expert stakeholder groups, which comprise senior clinicians, industry, professional bodies and other experts. We have Zoom meetings because that is the best way for us to come together from all over the United Kingdom and it means people do not have to travel. When we have our Zoom meetings we have fantastic contributions from all over the United Kingdom of Great Britain and Northern Ireland, and sometimes further afield.

I want to begin with a general point on the modern service frameworks. There is much to be thankful for in what the Government are doing and we want to focus on that as well, but there are also things that we want to ask for. Although the APPG warmly welcomed the initiative of the modern service frameworks, the Minister will not be surprised that we were disappointed that respiratory health was not included in the first wave. Respiratory health is an ideal candidate, I believe, as do others inside and outside the Chamber, for the next wave. What can the Minister do to include respiratory health in the next wave of the Government’s 10-year plan for health, which we very much welcome and are encouraged by?

The outcomes of COPD are widespread and have a huge impact on the NHS. I will give some statistics to show that. Sometimes, people hear statistics and are sceptical. I always think about “lies, damned lies, and statistics”, but the stats are important because they set the scene. Many times when we are looking at the objectives and targets for the NHS, we need the statistics before us, because they indicate the policies that hopefully the Government will follow.

Lung conditions, including COPD, are the largest cause of emergency hospital admissions, especially in winter, when respiratory admissions can increase by some 80%. These figures are worrying; we are in that season now, and we could see that figure. The rate of emergency admissions to hospital for COPD in England increased by 9% in 2024 compared with 2023; unfortunately, they are increasing consistently. That represents some 121,129 A&E admissions—significantly higher than in the previous year. Worryingly, the trends are upwards. I hope that the Minister, when she responds to the debate, can give us some ideas about how the Government can reverse those trends and reduce that figure.

COPD is the second most common cause of emergency admission in the United Kingdom, and 1.7 million people in the UK have been diagnosed with it. In my office, when we meet constituents, we help them with their benefits forms and try to put them on the pathway to get some help to deal with their health conditions. I have known many people over the years who, unfortunately, are no longer here today because COPD has taken their life. Others are on oxygen, just trying to survive every day. Again, that is quite worrying.

It has been estimated that there could be around 600,000 more people in the UK who are living with undiagnosed and untreated COPD. What can we do to identify those people and ensure that they understand what is happening to them, so they can get some help with the life that they will now lead? Lost productivity due to COPD is estimated to cost around £1.7 billion per year. There is a cost to every disease, but there is a real cost to this disease, and if we can diagnose and catch it earlier, perhaps we can reduce that sum.

My last point is about something quite worrying. Each year, around 30,000 people in the UK die from COPD. That is the reality experienced by some of my constituents I have met over the years, but who are no longer with us. The disease progresses so fast that people’s life expectancy is reduced. Deaths caused by respiratory diseases are more strongly linked to deprivation than deaths caused by any other major disease. People living in the poorest areas of the United Kingdom are five times more likely to die from COPD than those living in the richest areas. That is a real disparity, whereby people in deprived areas are more susceptible to COPD and their life expectancy is also reduced. I have another ask of the Minister: how can the Government address deprivation and its impact on particular areas, specifically when it comes to COPD?

Research from Asthma and Lung UK shows that someone from the poorest 10% of households is over two and a half times more likely to have COPD than someone from the most affluent 10% of households. That is a real disparity. If someone lives in an affluent area, they have 10% less chance of getting COPD than someone living in a deprived area.

We hope that the transition from hospital to community under the 10-year plan for the NHS will transform COPD outcomes in the most deprived areas. A survey by Asthma and Lung UK found that almost a quarter of people with COPD wait five years or more for a diagnosis, with one in eight of people with COPD waiting for over 10 years. Again, I have another ask of the Minister. How can we shorten the wait for a diagnosis of COPD? If we catch it earlier, we can reduce the impact on life expectancy and help with life conditions and how to reach a better level of care.

The same survey showed that only 9% of people with COPD in the UK were receiving good basic care. That is worrying. Again, as chair of the respiratory health APPG, it is one of the things that we hope to address. While the statistics are stark, the APPG also acknowledges and welcomes a huge amount of work undertaken by NHS England ahead of the winter months to relieve the pressure on the NHS. We are all here to make lives better, and not to make them worse, but sometimes we need to have a better idea of what needs to be done. The NHS can do much, but it cannot perform miracles. It can only do the best it can, so how do we help it to do so, given all the pressures it is under?

We commend the urgent and emergency care delivery plan, and Exercise Aegis, which will devolve accountability for winter readiness to the integrated care boards—probably a good idea. Under Aegis, NHS England will stress test winter preparedness by running seven regionally-led exercises. I ask the Minister for some detail on that, on what it means and how it will work—no doubt we are to hear that shortly. The initiative is welcome and a well thought-out plan, I believe—I am sure others will comment —that promises to deliver the regional outcomes that will make a huge difference. Only in the past few days have we realised that winter is coming—anyone who has not felt the cold must be wearing a strong and heavy coat—so will the Minister update us on the outcomes of the regional exercises and how they feed into the winter preparedness strategy?

We are busy in the APPG—Hugh and the team clearly do that for us—and recently we held a roundtable on the winter pressures in partnership with the Centre for Applied Respiratory Research Innovation and Impact—CARRii, to abbreviate all those words—which gave an outstanding presentation. Early next year, we will produce a short report, taking the outcomes of that meeting and the data from this year into account. We are happy to share it with the Minister, because I think it will be helpful when drawing up a better way to do things.

Key themes of the roundtable included an increase in vaccination rates—more focus on that has been because of, unfortunately, a slight reluctance to take up vaccination —and how we encourage that. At the Tuesday morning roundtable, with Lord Bethell from the other place, we had an opportunity to discuss how best to do that with those in the NHS, and with other companies and people who have a deep interest in the subject matter. Some of the ideas will be helpful for the future.

We need better infection control. COPD exacerbations are mainly driven by infections. How can we address and target that in the system? We must implement fully the five fundamentals of COPD care by the National Institute for Health and Care Excellence, which outline what effective management of care looks like, such as vaccination, smoking cessation and pulmonary rehabilitation. Recent analysis has found that expanding access to PR services to all eligible patients could result in £142.6 million of direct NHS savings related to reduced exacerbations, as well as a reduction of 194,000 bed days, 66,000 of which would be saved over the winter period.

Those figures cannot be ignored—at the end of the day, the NHS has to work within the figures, the money, it has available. When we look at the savings and the reduction in bed days, in particular over the winter period, we must try to do better. The final fundamentals are personalising self-management planning and optimising treatment for co-morbidities. Will the Minister please assure us that the NICE fundamentals of COPD care are being implemented consistently across the country? The Minister will know, because she is very knowledgeable and responsive to these issues, that the APPG strongly supports the 10-year plan and the three shifts, which are ideally placed to transform respiratory care and outcomes. Community delivery, especially, promises a great deal for improved respiratory outcomes by placing facilities closer to home. That is a better way to do it.

We welcome the work already under way to place respiratory services in community settings and the introduction of spirometry in all CDCs and community health services. This a really positive way forward. There is, however, evidence to suggest that not all patients receive spirometry tests. If we are going to introduce spirometry, we need to ensure that all patients can receive those tests. Will the Minister make sure that these tests be undertaken on all eligible patients?

Will the Minister also please look at the waiting lists for diagnostic testing and see whether they can be prioritised to test those at the highest risk first? That is a lot of asks—I have given the Minister and the shadow Minister a copy of my speech, so hopefully the Minister had all my questions in advance. I hate to throw around 20-odd questions at her in the space of an hour and a half and expect answers right away, but hopefully we can get those answers—I know that the civil servants who are here will work very hard to ensure that happens. Although it might be too late for this winter, perhaps that provision could be in place for people for next year.

We are also looking forward to the upcoming NICE guidance on the biologic therapies for COPD, which will be a complicated process. We will keep an eye on the implementation of these drugs when they are approved. The advancements in medicine cannot be ignored; it is really good to have them, and it is encouraging that we are living that bit longer now. We can now extend and improve the lives of people with diseases that would previously have killed them fairly young.

Finally, we have been looking at the incidental findings from lung cancer health checks. According to recent data, around 100,000 people who have been assessed under the targeted lung health check programme have been diagnosed with emphysema or symptoms of no recognised disease to date. What can be done to help those 100,000 and perhaps others facing those circumstances who have not yet been diagnosed?

Lastly, there is no onward referral from the lung health checks, and I think there should be. It would be helpful to have an assurance about how that could be achieved. I know that this is a complex area—it always is—and that lung cancer health checks are carefully targeted, particularly for those in our most deprived communities, who are least likely to be well served, but this provision would seem to fit perfectly in a modern service framework for respiratory health. So, I end where I began: I hope that this will happen sooner rather than later. I have made a lot of requests, but we are fortunate to have a Minister who responds in a way that gives us all encouragement. We have a real problem with COPD, and this debate gives us the chance to highlight the issue for patients. The winter pressures are on. I am pleased to see my friend, the hon. Member for Blaydon and Consett (Liz Twist). She is the co-chair of the APPG, and she will hopefully speak next. I look forward to hearing all the contributions, including from the shadow Minister, the hon. Member for Farnham and Bordon, and, ultimately, the Minister.

15:18

[Liz Twist (Blaydon and Consett) (Lab)]

It is a pleasure to take part in this debate with you as Chair, Mr Efford. I also thank the hon. Member for Strangford (Jim Shannon) for securing this important debate. He and I have worked together on the respiratory health APPG for some years now, and I know how committed he is to tackling this issue.

Like in many other places across the north-east, a great number of people—more than 2,500 people, in fact—are living in my constituency with the debilitating symptoms of COPD. In some parts of my constituency, the rate is almost twice the national average, and those are just the people we know about. Almost a quarter of those with COPD wait five years or longer for a diagnosis, and there are many more living with COPD who are undiagnosed and therefore untreated.

From the discussions I have with constituents who come to my local surgeries or contact my office, it is clear just how closely this condition tracks health inequalities. Nine in 10 cases are thought to be caused by smoking, which we know is associated with socioeconomic deprivation. Meanwhile, persistent exposure to damp and mould in poor-quality housing further contributes to and exacerbates lung problems. I have received messages from constituents receiving hospital care who are frightened to return to homes that they strongly feel are not safe places for them to be in. I have heard from others who struggle to walk long distances, for whom the reliability of public transport is a serious issue. This condition cuts across many areas of daily life.

The town of Consett in my constituency is well known locally for its freezing climate. We have had lots of snow in Consett this week, while I have been down here in Parliament. Although it is great to see people enjoying the snow, I know that such weather conditions make living with a lung condition even more challenging, leading to heightened admissions to hospital, as we heard from the hon. Member for Strangford. This debate is therefore timely and is a good opportunity to remind ourselves of the importance of improving access to diagnosis, treatment and care for people living with COPD.

The Government’s 10-year health plan has established the importance of prevention and care within the community. I am pleased with the progress we have made to tackle smoking prevalence through the Tobacco and Vapes Bill, and the progress made through Awaab’s law, which requires that problems of mould and damp are responded to quicker in the social housing sector. Locally in the north-east, our ICB performs well nationally for ensuring timely referrals to pulmonary rehabilitation services.

However, much more needs to be done nationally to ensure access to rehabilitation services. I know there is much more to do to ensure that all eligible patients have access to that treatment as well as biologic drugs. Both those interventions can make a huge difference to quality of life and reduce hospital admissions. I would be interested to hear the Minister’s views on the potential merits of a dedicated framework to bring those efforts together with work to expand early diagnosis, and on what more we can do to ensure that we catch and treat conditions early.

I thank Asthma + Lung UK and the APPG for respiratory health for their work in ensuring that COPD remains firmly on the agenda here in Parliament. My thanks go to constituents who have shared with their experiences with me, not just lately but over a number of years. I know just how devastating this condition can be, and I hope that we continue to work together to address the impact it has on our communities and people.

15:23

[Dr Al Pinkerton (Surrey Heath) (LD)]

It is a great pleasure to serve under your chairmanship, Mr Efford. I congratulate my dear friend, the hon. Member for Strangford (Jim Shannon), on securing this debate and on his long advocacy for both COPD and other respiratory conditions, which I know he does with his chairman for the APPG for respiratory health hat on. We thank him for all his work, and the vice-chair of that APPG, the hon. Member for Blaydon and Consett (Liz Twist), who spoke just before me.

As the hon. Members for Strangford and for Blaydon and Consett have both already said, COPD is the most challenging condition to live with. Many people go undiagnosed for far too long, believing their wheeze, cough and breathlessness is simply result of seasonal winter flu. But it does not go away; there is no cure, and when someone with COPD does catch something as common as the winter flu, it can rapidly escalate into other conditions, such as pneumonia. That is why treatment, early diagnosis and proper management are vital. However, a recent King’s College London report, carefully titled “A matter of life and breath”, revealed that COPD sufferers often feel like they live as second-class citizens in the UK—their voices go unheard. I know that the hon. Member for Strangford was involved in the launch of that report in Parliament back in May.

Respiratory illnesses are now one of the leading causes of hospital admissions in the UK, yet our healthcare system is still not optimised to support people with long-term conditions effectively. According to Asthma + Lung UK, there were 2,268,865 emergency hospital admissions for respiratory conditions in England between April 2024 and March 2025, a 23% increase compared with the year before. Worse still, in just the month of December 2024, more than 220,000 were admitted to hospital with breathing emergencies. That is not just a one-off; between April 2024 and March 2025, there were over 405,000 so-called bounce-back admissions, where people are discharged from hospital only to return to A&E within a month.

I have heard from numerous constituents of mine in Surrey Heath—not only those with COPD, but many others with chronic conditions—who frequently travel across the country for work or education. However, when they move, their medical records do not. Let us take the example of university students, who are not necessarily a high-risk population for COPD. They move between home and campus, yet they can be registered with only one GP surgery at a time. The result is delayed treatment, repeat diagnostics and even difficulty accessing the medication that they rely upon. The burden often falls hardest on those with complex conditions such as COPD, where timely diagnosis and regular specialist input can be life-saving.

I have a few key questions for the Government. First, do they agree that people with conditions such as COPD should not face the anxiety of being unable to access the right NHS specialist care, simply because they happen to live in the wrong part of the UK? Secondly, will they commit to stronger data sharing and a truly integrated, nationwide healthcare system, so that records follow the patient, not the other way around? Finally, what steps is the Minister taking to winter-proof the likes of Frimley Park hospital in my constituency, so that it can cope with additional demand and also provide support to those with diseases such as COPD that worsen in the colder months? People with COPD and other chronic illnesses deserve continuity of care, wherever they are living. Our NHS must be connected enough to deliver exactly that.

15:27

[Helen Morgan (North Shropshire) (LD)]

It is a pleasure to serve under your chairmanship, Mr Efford. I start by congratulating the hon. Member for Strangford (Jim Shannon), who is a friend of all of us in this House, on securing this debate and raising awareness of World Chronic Obstructive Pulmonary Disease Day, which took place yesterday. I thank him for his tireless campaigning for this cause, and for his excellent opening speech, which outlined the issues faced by COPD sufferers.

As we have heard, COPD is the name given to a group of health conditions that affect the lungs and cause breathing difficulties, such as emphysema and chronic bronchitis. Patients with COPD may face symptoms such as shortness of breath, a chesty cough, frequent chest infections and wheezing, which get progressively worse over time and may be exacerbated during the winter months. As someone who has had asthma from childhood, I know at first hand the fear, frustration and disruption to daily life that gasping for breath can cause. It is critical that there is a plan in place to manage respiratory disease, given that we may be facing a devasting winter crisis in the NHS once more.

The most recent data published by the NHS shows that there were over 1.17 million patients recorded by GPs as having COPD in England in 2023-24. The National Institute for Care Excellence warns that the real number of sufferers may be much higher, noting that previous Government research put the number at around 3 million in the UK, 2 million of whom remain undiagnosed. Approximately one in 10 adults over the age of 40 has COPD in the UK, at a cost of £2 billion a year to the NHS.

As the main cause of COPD is smoking, it is a highly preventable condition. I welcome the Government’s introduction of legislation to enable a smoke-free generation, but we must also consider those who have already started smoking and who are finding it hard to quit, or those who can circumvent the provisions of the Tobacco and Vapes Bill.

Smoking is much more common in deprived areas, as we have already heard, so COPD is also a stark indicator of social and health inequalities in this country. The Liberal Democrats want the new Government to take urgent action to support people to live healthier lives, starting by reversing in full the Conservative cuts to funding for public health, of which smoking cessation services are a critical part. I am sure all Members agree that prevention is better than cure, and helping smokers to kick the habit will not only reduce their risk of debilitating illness but will save taxpayers money in the long run. The cost of COPD is £2 billion per annum, and everyone benefits if fewer people require treatment for smoking-related illness.

Along with smoking, long-term exposure to air pollution may be a cause of COPD. The Liberal Democrats have pledged to reduce air pollution; to protect people, especially children, from breathing in harmful pollutants by passing a clean air Act based on World Health Organisation guidelines and enforced by a new air quality agency; and to improve public transport and active travel to reduce the harm caused by air pollution at home, school and work. I would welcome the Minister’s thoughts on those proposals, which would drastically reduce avoidable respiratory diseases.

The theme for World COPD Day this year is “Short of Breath, Think COPD”, and it aims to raise awareness of underdiagnosis and misdiagnosis of COPD. As I mentioned, there could be 2 million people undiagnosed in the UK who are missing out on essential treatment and advice on how best to manage their debilitating condition. NICE recommends that COPD should be suspected in anyone aged over 35 with a risk factor for COPD and symptoms of breathlessness, chronic cough, regular phlegm production, frequent chest infections in the winter, or wheezing.

The Liberal Democrats have called for anyone with a long-term health condition, including COPD, to have a named GP, which would improve the continuity and therefore the quality of their care. People with COPD consistently report difficulties accessing services that are essential to managing their condition, including GP appointments, specialist care and pulmonary rehabilitation. They also experience poor communication between different healthcare providers and inadequate follow-up after hospital discharge.

As we have heard, COPD patients are often left in the dark with inadequate information about their condition when they are first diagnosed. Better continuity of care in the community would surely help to overcome at least some of those issues. To achieve that, we need the Government to be much more ambitious in their plans to increase GP numbers. We need them to adopt Lib Dem plans to retain and recruit 8,000 more GPs over this Parliament to deliver that improvement in care.

We are also campaigning to improve the speed of new treatments by expanding the capacity of the Medicines and Healthcare products Regulatory Agency. We are also pressing for better social care, including for people with COPD who are struggling to manage independently. We would provide more support for family carers through initiatives such as the right to respite breaks, paid carer’s leave and an end to the cliff edge in the way that carer’s allowance is paid, so that no one is forced to pay back thousands of pounds because they worked an extra hour a week.

We would also help people who struggle to get into work because of their illness, with a new right to flexible working and the right to work from home unless there is a really good business reason why that is not possible. We would make it easier for people with long-term conditions, such as COPD and those with disabilities, to access public life, including the world of work, through a range of measures that allow better physical access and proper adjustment to the workplace.

Many people with COPD are at risk of a stay in hospital, and they are often unable to get home after that because of the crisis in social care, which is putting even more strain on the NHS. The Government established the Casey commission to find a cross-party solution to the social care problem, and I welcome that, but I have to report that despite a promising opening roundtable in September, there have been no further talks. Will the Minister update us on the progress of that work?

The winter presents an immediate problem. There are warnings of a particularly bad flu season, which is causing concern for everyone who is more vulnerable to respiratory illness, including those with COPD. My local hospital, Robert Jones and Agnes Hunt Orthopaedic hospital, and the Shrewsbury and Telford hospital NHS trust have already introduced some mandatory mask wearing to reduce the risk of transmission of respiratory disease in the hospital. That means that an effective vaccination programme is especially important this year.

I was concerned by news that covid vaccination eligibility has been significantly reduced. This autumn and winter, vaccination is being offered only to people over 75 and those with a weakened immune system. People with chronic respiratory disease, including COPD and asthma, have been excluded despite the clear risk—I speak from too many personal 2 am nebuliser experiences—that even a mild respiratory infection poses for them. Also excluded are the main carer for an older or disabled person, those who are in receipt of carer’s allowance or who are living with someone who has a weakened immune system, and, perhaps most surprisingly, frontline health and social care workers.

All those people remain eligible for a flu vaccine, and that is good. Even though covid is now considered to be a mild disease, time off for NHS and care workers when services are at their most pressured, as well as the significant risk of transmission to vulnerable patients, is concerning. Will the Government consider a review of the decision to restrict access to covid vaccines this year? Can the Minister provide statistics on the uptake so far of flu vaccines within different groups and outline what steps she is taking to ensure high levels of uptake among NHS and care workers?

In conclusion, COPD is a debilitating condition and, as with many conditions in the UK, there is something of a postcode lottery in the quality of care patients receive. I welcome the Government’s roll-out of the NHS RightCare COPD pathway and the National Respiratory Audit programme, along with plans to improve access to pulmonary rehabilitation. I would be grateful if the Minister updated us in her closing remarks on progress with those programmes, as well as answering my questions about vaccine roll-out, support for carers and the Casey commission, access to a named GP, and full restoration of the public health grant, including for smoking cessation services.

15:35

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Efford. I am grateful to the hon. Member for Strangford (Jim Shannon) for securing this debate the day after World Chronic Obstructive Pulmonary Disease day. He gave an excellent speech, although I think he was being characteristically modest when he mentioned his dancing ability—I am sure he is much better than he claims.

As we have heard, COPD is a group of conditions that too often goes unnoticed until it is dangerously advanced. More than 1.7 million people across the UK have a COPD diagnosis. However, NICE estimates that around 600,000 more are living with the condition undiagnosed, and indeed this afternoon we heard figures that are even higher than that.

I am fortunate to have a relatively low rate of COPD in my constituency, at about 1.46%, but that figure masks the variation within my constituency. Those differences are reflected across the country: rates are significantly higher in the north of England, and in the 10% most deprived areas the prevalence is nearly double. People living in the poorest areas are five times more likely to die from COPD than those in the wealthiest. Research from Asthma and Lung UK shows that the poorest 10% of households are more than two and a half times more likely to have COPD than someone from the most affluent 10%. As the hon. Member for Strangford rightly highlighted, this is, in every sense, a disease that tracks inequality. Where someone lives should never decide how long they live, yet for COPD far too often it does.

Before the pandemic, around 70% of people diagnosed with COPD said they faced barriers to accessing that diagnosis, and 14% were initially misdiagnosed—often told that they had a chest infection or a lingering cough. Some were simply sent away after raising concerns with their GP. However, the pandemic made a serious problem worse: Government figures demonstrate that already inadequate diagnosis rates plummeted, and they show little sign of recovering. As the hon. Member for Strangford mentioned, spirometry—the gold-standard diagnostic test—which has not returned to pre-pandemic levels, continues to be a problem.

The consequences of that pause are stark. There was a 51% reduction in diagnoses in 2020 compared with the year before, meaning that around 46,000 people missed out on a diagnosis in that year alone, and around 92,000 over the course of the pandemic. As the hon. Member for Blaydon and Consett (Liz Twist) said, late diagnosis means more advanced disease and higher mortality, more frequent exacerbations and quicker deterioration in quality of life. Those flare-ups can cause permanent lung damage and require long hospital stays. COPD is now the second largest cause of emergency hospital admissions, rising three times faster than general admissions.

The pressure on the NHS is enormous: an estimated £3.9 billion a year, including £1.4 billion for exacerbations alone. Lost productivity costs £1.7 billion, and reduced quality of life accounts for a further £2.2 billion. When diagnosis fails, costs rise, outcomes worsen and patients suffer the price of delay.

As the hon. Member for Surrey Heath (Dr Pinkerton) has rightly pointed out, late diagnosis is not the only driver of pressure. Asthma and Lung UK, formerly the British Lung Foundation, found that patients who received the five fundamentals of COPD care experienced fewer flare-ups and were better equipped to manage their symptoms, yet more than three quarters of respondents said that they were missing at least one part of that basic care. Those with the most recent diagnoses were the least likely to receive the full package, so the situation is getting worse, not better. Asthma and Lung UK notes that many people must effectively learn to navigate the NHS themselves to access the care that they need. That is not acceptable. These are people who are already struggling, and they should not have to fight the system as well as the disease.

Around 420,000 people in the UK may have had their working lives cut short by COPD. More than half of respondents to the Asthma and Lung UK survey said that their mental health had worsened since diagnosis, so we can and must do better. The NHS long-term plan includes commitments on respiratory disease, including for early detection and improved access to pulmonary rehabilitation. I would be grateful if the Minister updated the House on progress towards those commitments. This November, waiting lists continue to rise. We need a credible strategy to ensure that the NHS can manage the winter safely while maintaining high-quality care. We need a realistic plan to address the continuing backlog in elective and non-emergency care, and a targeted approach to address persistent gaps in respiratory services.

The national respiratory audit programme—formerly the national asthma and COPD audit programme—was launched in 2018 and is led by the Royal College of Physicians. It has been invaluable in identifying gaps and variations in care. As part of the programme, NHS England developed a best practice tariff for COPD, which is met when 60% of COPD patients admitted for an exacerbation receive specialist input after 24 hours and when all COPD patients receive a discharge bundle.

I have mentioned it before in the House, but one of my proudest career moments was working for the Getting It Right First Time programme. In 2021, our respiratory medicine report, published by Dr Martin Allen during the pandemic—it was, therefore, focused on the immediate problems—raised a number of issues. For example, pulmonary rehabilitation remains one of the most effective treatments available for COPD. Of those who complete the programme, 90% report better quality of life or improved exercise capacity. The long-term plan proposes expanding access by 2028. If achieved, that could prevent half a million exacerbations and avoid 80,000 admissions. As 2028 is not that far away, will the Minister update on progress towards those targets?

The NHS RightCare pathway provides a comprehensive framework for improving diagnosis, management and treatment. It highlights the importance of timely pulmonary rehabilitation and early intervention, so I welcome the Government’s rolling it out. Finally, tackling smoking remains fundamental. Between 2022 and 2023, there were around 400,000 hospital admissions attributable to smoking, and 16% of all respiratory admissions were smoking-related. Between 75% and 85% of COPD deaths remain linked to smoking, yet only around half of COPD inpatient services report having a dedicated tobacco dependency adviser. What are the Government going to do to improve that situation?

I call on the Minister to take urgent action, first by implementing a national strategy to raise awareness, strengthen early diagnosis and reduce risk factors such as smoking and air pollution; secondly, by ensuring that all COPD patients have timely access to treatment, pulmonary rehabilitation, and integrated health and social care support for patients and carers; and, thirdly, by committing to increasing research investment, and to introducing innovative treatments and transparent data-driven accountability to improve outcomes and reduce avoidable hospitalisations. We cannot keep treating COPD as a winter crisis when it is, in truth, a year-round emergency. The time to act is now.

The evidence is clear. Too many people remain undiagnosed, too many are diagnosed too late, too many do not receive the basic standard of care to which they are entitled and too many end up in hospital when their deterioration could have been prevented. We have the data. We have the clinical consensus. We have the pathways. We do not lack knowledge; we lack resolve. People living with COPD deserve timely, high-quality care and the support that they need to live fuller, healthier lives. It is within our gift to deliver that; let us not fail them.

15:44

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

It is a pleasure, as always, to serve under your chairship, Mr Efford. I thank the hon. Member for Strangford (Jim Shannon) for securing this timely debate, as we mark World COPD Day. As hon. Members have clearly demonstrated in this debate, tackling COPD does not lend itself to one area of activity; that point was well made by my hon. Friend the Member for Blaydon and Consett (Liz Twist).

COPD is known to affect 1.5 million people in the UK but, due to uncertainties, that number, as has been stated, could well be much higher. Improvements are needed across society and the healthcare system to reduce the incidence of COPD and help people living with the condition—people like my mum, Margaret—to lead healthier, longer lives. Our 10-year plan is built around the recognition that widespread change is needed to shift from treating COPD to preventing it, to ensure that those living with COPD receive care in the areas where they live and to embrace new technology to diagnose COPD earlier. I reassure the shadow Minister that the National Institute for Health and Care Research welcomes all proposals for research, and I encourage researchers to submit proposals on COPD and similar respiratory conditions for consideration.

Before I speak about the actions we are taking through the plan and more broadly, I want to address the points about a modern service framework for respiratory disease. Frameworks for cardiovascular disease and severe mental illness and the first ever service framework for frailty and dementia will be developed first. However, there will be more—those are just the first three. The criteria for determining future frameworks will be based on where there is potential for rapid and significant improvements in quality of care and productivity. I assure hon. Members that respiratory disease will be considered alongside many other things as we bring forward more modern service frameworks in the future.

As has been said, smoking is the No. 1 preventable cause of COPD. The Tobacco and Vapes Bill will be the biggest public health intervention since Labour’s indoor smoking ban in 2007. The Bill also allows us to expand current indoor smoking restrictions to outdoor public places and workplaces. In England, we are considering extending smoke-free outdoor places to outside schools, children’s playgrounds and hospitals. Prevention will always be better than cure. As part of our health mission, we will shift the health system from treatment to prevention by tackling the social determinants of health. The public health allocations, including for smoking cessation, will be announced shortly.

In terms of vaccines, the primary aim of the national covid-19 vaccination programme remains the prevention of serious illness, hospitalisations and deaths arising from covid-19. The independent Joint Committee on Vaccination and Immunisation has advised that population immunity to covid-19 has been significantly increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. The focus of the JCVI-advised programme has therefore moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease, including mortality: the oldest adults and individuals who are immunosuppressed.

In line with the JCVI advice, a covid-19 vaccination is being offered to adults aged 75 years and over, residents in care homes for older adults, and individuals aged six months and over who are immunosuppressed. I do not have to hand the data on uptake for the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), but the Government’s vaccine strategy is being rolled out and is focused on stabilising and increasing vaccine take-up. I will write to the hon. Lady with an update on the data following this debate.

In terms of housing and air quality, the Tobacco and Vapes Bill is the first step, but it is only part of the action that we are taking to improve air quality. We are working across Government with the Department for Environment, Food and Rural Affairs to tackle air pollution and with the Department for Energy Security and Net Zero to fix housing and reduce damp and mould, both of which can exacerbate COPD, as hon. Members have said today, and make life much harder for people than it needs to be.

We are also working with the Department for Work and Pensions to support people with COPD to get back into and stay in work. In March, we announced in the “Pathways to Work” Green Paper that we will establish a new guarantee of support for all disabled people and people with long-term health conditions claiming out-of-work benefits who want help to get into or return to work. That will be backed up by £1.9 billion of new funding by the end of the decade.

Unemployment is worst in the most deprived areas of the country, and those areas have the worst health inequalities. COPD disproportionately affects people in deprived areas and we intend to address that. Yesterday, we announced the publication of our men’s health strategy, which includes our commitment to addressing entrenched health inequalities in ex-mining and industrial communities, where economic transition and occupational legacies have led to persistent respiratory and cardiovascular disease burdens. As part of the strategy, we will expand the existing respiratory pathways transformation fund initiative by investing an additional £1 million this year, through the Oxfordshire health innovation network, to develop targeted, case-finding initiatives in former coalfield areas. That will help us to identify the individuals who need support to access appropriate local services. We will continue to capture learning in the men’s health strategy “one year on” report.

The hon. Member for Strangford raised coverage of spirometry and the progress made to increase coverage of this diagnosis service in the community. I also assure the shadow Minister that we are shifting care from hospitals to the community, as it is one of the key pillars of the 10-year plan, and we are building on progress so far. The number of community diagnostic centres reporting spirometry testing capacity is growing and will continue to as more sites come online. So far this year, we have seen an increase in CDC spirometry testing of 2,000 tests a month—more than in the previous year.

Preventing and diagnosing COPD are two key areas we are making improvements in, but we also want to ensure that people with COPD have healthier lives. As highlighted by the shadow Minister, pulmonary rehabilitation is a key intervention to improve the health of people with COPD and reduce pressure on NHS hospitals. As he knows, we inherited very low rates of people accessing this service, and I want briefly to set out the action we are taking to change that.

We want to ensure equitable access to these services and reduce health inequalities. To address that, NHS England has published commissioning standards for pulmonary rehabilitation, setting out the benchmarks that high-quality services should aim for, while recognising that cardiac comorbidity is highly prevalent in patients attending pulmonary rehabilitation. In addition, the nine health systems across England have been awarded funding totalling £2.61 million through the pathway transformation fund to deliver innovative projects between October 2025 and March 2026, to drive system-wide transformation in asthma and COPD care. I confirm to the hon. Member for Strangford that reporting on the outcomes of the PTF projects will follow later in 2026.

It is vital that all screening programmes are evidence-based. That is why the Government are guided by the independent scientific advice of the UK National Screening Committee. Lung cancer screening has been very positive, particularly for deprived communities, and is growing year on year. I visited a programme in the north-west recently and saw the amazing work that they were doing to identify early-stage lung disease. It is an opportunity for many more people to be recognised and treated for lung conditions who previously were not receiving support. Where emphysema is found, the screening programme refers people to their GP. GPs have established clinical pathways for supporting people with COPD.

The hon. Member for Strangford is understandably interested in biologic therapies, which have also been mentioned by other Members. Biologic therapies for COPD will be commissioned by ICBs, should NICE approve them. The high cost of biologics means that a specialist approach by ICBs is needed, but we cannot pre-empt the findings of NICE, so we will wait to see the outcome of that.

I want briefly to cover the points made on winter planning. The NHS chief executive wrote to the NHS in September following the testing of winter plans, and set out key areas for learning for providers and systems. It included the need for robust plans to maximise vaccination rates and proactively to manage rising risk to COPD patients during the winter, including the optimisation of care and remote monitoring, greater emphasis on self-management and education, and strengthening community support. The actions being taken as part of winter planning, and the other actions I have set out today on smoking cessation and pulmonary rehabilitation, directly relate to the NICE fundamentals of COPD care. I hope that the totality of that work reassures the hon. Members for Strangford and for Surrey Heath that we are committed to NICE’s fundamentals being delivered across the country.

Too many people have had their lives cut short by COPD—people such as my cousin’s husband, Steve Ormerwood, who we lost to COPD far too young. His wife, Janet, his children, Adam and Joanne, his young granddaughter, Ada, and all our family feel his loss keenly. COPD is a lifelong condition, but it can and should be prevented. This Government take our responsibility to that goal with the utmost seriousness, as the cross-Government approach to that mission demonstrates. Equally serious is the need to ensure that those living with COPD, especially from communities that have been overlooked, are supported to live healthier and longer lives.

15:55

[Jim Shannon]

I thank all hon. Members for their contributions. I particularly thank the hon. Member for Blaydon and Consett (Liz Twist). She and I have been friends for ages and ages—so far back that I maybe had hair at that time. She underlined two issues: access to public transport, and how difficult it is for people to return home from hospital. She was keen to welcome the progress on the Tobacco and Vapes Bill and on access to drugs. She is no longer a Parliamentary Private Secretary, so she can now be active on the APPG—we are very much looking forward to having her energy back.

The hon. Member for Surrey Heath (Dr Pinkerton) also set the scene very helpfully. COPD never goes away; it escalates, so how do we address it? He said that there were 200,000 admissions to hospital due to respiratory ill health in the last year. He also talked about access to data and to medical care for COPD. It is sometimes a postcode lottery in the United Kingdom, and that has to change.

The hon. Member for North Shropshire (Helen Morgan) talked about chronic bronchitis and rehabilitation. She said that early diagnosis reduces the cost to the NHS. Shortness of breath means that there should be more checks for COPD. She said that anyone over 35 should get checked. That is very wise—we should all take note of that. She also referred to the Lib Dem ambition to recruit another 8,000 GPs, and she spoke about vaccination.

The hon. Member for Farnham and Bordon (Gregory Stafford) made an excellent speech—it was a real pleasure to hear it. He referred to the inequality and deprivation across the United Kingdom, and talked about how to do spirometry tests better. The pressure on the NHS is enormous. He said that pulmonary rehabilitation treatment is a key way of responding, and we very much welcome that. He also referred to other COPD interventions, and said that this is a year-round emergency.

I am very pleased to have the Minister here to respond to our requests. Anyone listening to her speech would recognise that she is keen, eager and energetic in giving us the answers that we are looking for. I am conscious of the look that you are giving me, Mr Efford, so I will be very quick. She said that her mother has COPD, and therefore this is a personal issue for her. She is as keen as all of us to see results. She set out the case for the prevention of COPD, and said it is the next disease to be considered in the respiratory service framework—hopefully in the next phase. I am looking to her to see whether the Government can deliver on that.

Prevention is better than cure. We must work harder to introduce a vaccination programme. The hon. Member for Blaydon and Consett referred to housing and air quality. We need a pathway to work so that those with long-term illnesses can come back to work. The Minister set out lots of positive things. She referred to deprivation, which we all know about. She spoke about spirometry care from hospital to the community, pulmonary rehabilitation, which is key to reducing COPD, and lung cancer screening—all good stuff.

I want to put on the record a big thank you to all those who participated, to Hugh, Will and the team in the Public Gallery for all that they have done, to you, Mr Efford, for your patience, and to the civil servants—they are not often thanked, but let us thank them for what they do.

Question put and agreed to.

Resolved,

That this House has considered World COPD Day.

16:00

Sitting adjourned.