The charity Asthma + Lung UK Scotland is calling for better systems to diagnose people with lung conditions so they can get the care they need to keep out of hospital – saving lives and millions of pounds of NHS spending.

The charity is calling for the urgent establishment of easily accessible respiratory diagnostic hubs across Scotland.

They say the centres should offer local people testing to help diagnose a variety of respiratory conditions, using a “one-stop shop” approach where people who are tested are then diagnosed and referred in a single, streamlined service.

Lung conditions are the third biggest killer in Scotland. The charity says as many as 49,000 people in Scotland are misdiagnosed with asthma when they have another condition, costing an estimated £8.5m every year.

It has published a report Early Detection, Better Outcomes making the case for neighbourhood respiratory diagnostic services

Vivienne Gaynor from Edinburgh runs a support group for people with chronic obstructive pulmonary disease (COPD). She says it took six years to be diagnosed correctly with the condition:

“Getting an early diagnosis for COPD is so important, but sadly, for many people, including myself, this isn’t always what happens.  

“I was treated for asthma, but when I hit my mid 40s, my breathing changed, and my inhalers stopped working as well. I kept getting chest infections, wheezing all the time, tired and becoming really breathless.  

“Every time I went back to the GP, I was told it was just my asthma, but to me there was clearly something else wrong. After six years, I got a message from my GP to pick up my COPD inhalers. And that was it – there was no explanation and no support. I swapped surgeries straightaway, and since then, the treatment I have received has been pretty good, and I realise I’m lucky for that. 

“The impact of the delayed diagnosis meant that I had to give up the job I loved as a mental health advocate and now have to use a mobility scooter to get around.

“Lung health isn’t taken seriously enough. If I had been suffering with cancer or a heart problem, I don’t think I’d have had to wait so long for a diagnosis.”

The cost of delay

Asthma + Lung UK Scotland says COPD affects people’s ability to live active lives and makes them more susceptible to other health problems – while late diagnosis results in a 16% increase in direct costs per person over the two years following a COPD diagnosis.

The Head of Asthma + Lung UK Scotland Joseph Carter says people in Scotland are currently not getting access to vital diagnostic tests:

“This creates a barrier to accessing the care and support that is crucial to slowing down lung damage and reducing life-threatening exacerbations and hospital admissions.

“As Scotland heads deeper into winter, A&E departments are filling up with people struggling to breathe. Many of these emergency admissions could be avoided with earlier diagnosis of hidden breathing conditions.

“Our new report, Early Detection, Better Outcomes: Neighbourhood Respiratory Diagnostics, shows that the new breathlessness hub model offers a solution to rethink respiratory diagnostics. By offering testing to a wider population, neighbourhood ways of working can bring efficient and effective services closer to people with lung conditions when they need it. 

“The most cost-effective location to deliver diagnostic tests is in the community, closer to people’s homes; something of particular value for people with lung conditions from rural communities, for those that have a disability or illness, or those without the ability to travel easily.” 

Analysis by PwC and Asthma + Lung UK in 2023 found an uptake of one diagnostic test, spirometry testing, in primary care by 40% of those eligible could save £3.6million and a lead to a reduction of 3,847 bed days occupied per year in Scotland.

The report also found that if fractional exhaled nitric oxide (FeNO), a test that measures the levels of nitric oxide in breath, were made available to all GPs in Scotland, its use could save £6.2 million by optimising asthma treatment.

 

Read more: Stalled smoking rates spark funding questions; Weight loss drugs linked to asthma improvements; Chronic illness combination may double depression risk; Charities urge action on poverty’s toll on lung health

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