Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to identify (a) undiagnosed patients with chronic obstructive pulmonary disease (COPD), and (b) COPD patients who are managed in primary care that should have their management escalated to specialist care in Greater Manchester ICB.

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 including via spirometry tests, and through 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% of patients who complete a programme.

Within NHS Greater Manchester, action being taken to address COPD includes:

- improving equity of access to diagnostic spirometry and fractional exhaled nitric oxide, 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.

Data on the average time to diagnosis of COPD following patient contact with their general practitioner (GP) is not available. COPD diagnosis typically involves a spirometry test, and data related to such tests may be available at the level of individual GP practices and secondary care providers but is not yet routinely collected in national datasets or in Greater Manchester Integrated Care Board. Furthermore, the test is also used in the diagnosis of other respiratory conditions, not just COPD.