World COPD Day

Ashley Dalton Excerpts

Thursday 20th November 2025 Westminster Hall

[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.