Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to help tackle health inequalities linked to the (a) diagnosis and (b) management of chronic obstructive pulmonary disease in the NHS Greater Manchester Integrated Care Board.

Respiratory disease, including chronic obstructive pulmonary disease (COPD), is a clinical priority and the National Health Service is investing in the provision of more and better rehabilitation services for respiratory patients. This has the objective of improving outcomes for people with COPD through early diagnosis and increased access to treatments.

The NHS RightCare COPD pathway has been rolled out nationally and defines the optimal service for people with COPD. Furthermore, the National Respiratory Audit Programme aims to improve quality of care, services, and clinical outcomes for patients with asthma and COPD, by collecting and providing data on a range of indicators and pulmonary rehabilitation activity

A national programme of work is underway to support systems with improving access to Pulmonary Rehabilitation for the eligible population; increase capacity of provision to reduce waiting lists; and improve the quality and consistency of rehabilitation programmes through accreditation. Pulmonary rehabilitation is effective for people with COPD, improving exercise capacity or increased quality of life in 90% patients who complete a programme.

The NHS England Core20PLUS5 approach strives to inform action that targets the most deprived 20% of the population and other inclusion health groups, with the aim of reducing health inequalities. The approach focuses on improving the 5 clinical areas at most need of accelerated improvement, namely cardiovascular disease, cancer, respiratory, maternity and mental health outcomes, in the poorest 20 percent of the population, along with other disadvantaged population groups identified at a local level.

Within NHS Greater Manchester, steps to address health inequalities linked to COPD include: improving equity of access to diagnostic spirometry and FeNO, particularly for disadvantaged population groups; increasing capacity and reducing waiting times for pulmonary rehabilitation services; increasing vaccination uptake and focusing on secondary prevention of pneumonia; running smoking cessation services; and introducing a respiratory standard to improve quality in general practice in managing COPD.

This standard utilises a tool to identify patients with COPD who are at the highest risk and asks practices to do an enhanced review and management of these patients to help manage their COPD better.