World COPD Day

Gregory Stafford Excerpts

Thursday 20th November 2025 Westminster Hall

[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.