Paulette Hamilton

Total trade in goods and services (exports plus imports) between the UK and Morocco was £4 billion in the 12 months to June 2024, an increase of 11% or £378 million in current prices, from the previous 12 months.

UK businesses can access DBT’s business support via Great.gov.uk, the Business Support Service, their local Growth Hub, and Help to Grow.

DBT’s trade promotion plan includes trade missions that will bring Moroccan and UK entrepreneurs together. This includes recent trade missions building up to the World Cup in 2030, rail sector and airport sector missions, with small businesses an important part of these delegations.

Currently there are no plans to include spirometry and FeNO testing in the GP contract. In many areas, spirometry and FeNO testing services are delivered through Local Enhanced Services (LESs), which are funded separately to global sum payments.

Integrated care boards, as commissioners of primary care, are responsible for commissioning LESs which practices can opt into, which vary in scope and funding to fit the needs of local areas. In areas where spirometry and FeNO testing are not commissioned through a LES, it is the commissioner’s responsibility to ensure these services are available to patients.

Spirometry testing is provided at the Washwood Heath Community Diagnostic Centre (CDC), along with other respiratory diagnostic tests such as fractional exhaled nitric oxide and lung function tests. The same tests will also be available at the North Solihull and South Birmingham CDCs when they go live next year. Mobilisation meetings are underway with the provider to establish that these services are ready to go live.

All tests and funding seen in the CDC have a tariff attached to them, which incentivises systems to develop diagnostic pathways, including for respiratory health, that take place in the community. These tests are local, accessible, and offer timely appointments. There are now three CDCs approved in Birmingham and Solihull, which shows a system shift to a community-based delivery model for all diagnostics, and spirometry testing is key to diagnosis a number of conditions affecting a large number of the local population.

In addition to the development of community diagnostic provision, on Monday 4 November the Birmingham Solihull Integrated Care Board (ICB) launched a system-wide campaign to encourage people to ‘breathe easy’ by getting their vaccines. Focusing primarily on flu, COVID-19, and the respiratory syncytial virus, the Breathe Easy campaign was designed to engage with people who are over 65 years old and living in the postcodes where it is known that vaccine uptake is low, as well as those who are aged six months to 64 years old and who have an increased risk of getting seriously ill from COVID-19 because of a health condition or treatment. The ICB is also urging pregnant women who are between 28 and 32 weeks of their pregnancy to ensure they are doing all they can to protect themselves and their unborn baby.

Radio, bus stop, bus interior, community radio, billboard, online, and supermarket adverts are all currently live, and will run until Christmas 2024. This campaign forms part of the integrated care system’s winter communications plan, which has been developed to bring partners together across the system to help create a movement asking people to take personal responsibility, drive action, increase trust in community health services, and educate, to prevent ill-health and ultimately protect the health of yourself, others, and the local National Health Service.

System partners are working collaboratively to improve pathways between health care professionals, and to remove barriers in referrals to community-based services and hospital acute setting clinics. This will support admission avoidance, and ensure that patients are receiving the right care in the right place, more quickly.

An example of this is the work between the West Midlands Ambulance Service University NHS Foundation Trust (WMAS) and urgent community response, who are supporting the WMAS with direct referrals into their service, and providing a call before you convey the telephone line for ambulance clinicians on the scene with patients. Increasing the workforce skill mix in the urgent community response to support with decision making will avoid admissions. Support to care homes to ensure they can safely monitor and escalate, where patients become unwell, to appropriate health care professionals has been supported by urgent community response teams and virtual ward teams. We are also improving respiratory virtual ward utilisation in collaboration with both the University Hospitals Birmingham NHS Foundation Trust and the Birmingham Community Healthcare NHS Foundation Trust.

Following a significant drop in the volume of spirometry during the pandemic, NHS England has already worked with a range of partners, including Asthma and Lung UK, the British Thoracic Society, the Association of Respiratory Technology and Physiology, and clinical leads to develop a package for systems containing the information and support required to help increase the number of people receiving early and accurate diagnosis for respiratory disease.

NHS England’s priorities and operational planning guidance for 2024/25 also highlights the importance of timely access to diagnostics, including spirometry, asking systems to utilise new diagnostic capacity in the community to commission these tests. Additional funding has been made available to systems in 2021/22, 2022/23, and 2023/24 for the training and accreditation of staff in the provision and interpretation of quality assured spirometry, a key component of an early and accurate diagnosis. In 2023/24 and 2024/25, the national team is financially supporting systems to take innovative approaches to expanding access to their diagnostic services, focusing particularly on addressing health inequalities.