To address under-diagnosis or late diagnosis of respiratory conditions, the NHS Long Term Plan builds on the existing NHS RightCare programme to reduce variation in spirometry testing across the country. It wants primary care networks to support the diagnosis of respiratory conditions with more primary care health professionals being “trained and accredited to provide the specialist input required to interpret results.”1

The Plan also says there should also be an increase in uptake of pulmonary rehabilitation for people with COPD. This is a structured exercise and education programme designed for those with lung disease or breathlessness but is currently only offered to about 13% of eligible patients, mainly those with severe COPD.

Primary care will be involved in identifying eligible patients from existing COPD registers who have not previously been referred to rehabilitation. In addition, there will be new models of providing rehabilitation for mild COPD, including digital tools to support rehabilitation and self-management.

For asthma, “pharmacists in primary care networks will undertake a range of medicine reviews, including educating patients on the correct use of inhalers and contributing to multidisciplinary working.” Targeted interventions will aim to support:

·       reductions in the use of short acting bronchodilator inhalers

·       switching to dry powder inhalers where clinically appropriate, (to reduce use of fluorinated gases)

·       the uptake of new smart inhalers, as clinically indicated.