Respiratory diseases cost the NHS in the Black Country and West Birmingham (BCWB) more than £115 million each year.

It affects one in five people in England and is the biggest cause of death, with hospital admissions for lung disease rising over the past seven years.

The BCWB system is working to identify good practice in areas where they are successfully reducing the need for people to be admitted to hospital, so that we can improve outcomes and experiences for local people.

This will include more work around early diagnosis. Currently a third of people who attend hospital with Chronic Obstructive Pulmonary Disease (COPD) have symptoms that have worsened over time – yet this is the first time they are diagnosed with the disease. By 2024/25 we aim to detect 80 per cent of our estimated people living with COPD.

If funding is available, a lung screening programme will be rolled out as evidence suggests this will detect more people with lung cancer, COPD and other respiratory diseases.

In addition to this, it’s estimated that around 2,000 people in the BCWB could benefit from pulmonary rehabilitation each year and aim to increase referrals and improve the quality of this service so that outcomes for patients are positive.

Improvements will be made by:

• Reviewing current services and understanding how much is being invested and whether this is good value for money or if further investment is needed
• Ensure patients with COPD are referred to rehabilitation
• Encouraging acute NHS Trusts to increase the number of people receiving the COPD discharge bundle which includes referral to pulmonary rehabilitation
• Additional funding may be provided as part of the Long-Term Plan.

We also know that be expanding our pulmonary rehabilitation services over the next five years, around 200 hospital admissions can be avoided each year by 2024/25.

Support for people with respiratory disease

Eighty-seven per cent of the BCWB spend on asthma goes on medicines, but incorrect use of medication can also contribute to poorer health outcomes and increased risk of symptoms worsening, or patients being admitted to hospital.

The BCWB system has already reviewed the COPD inhaler treatment guidelines and developed a standard format, providing training on this for more than 400 people.

The training supports the implementation of a range of medicine reviews; educating people on the correct use of inhalers; reducing use of short acting bronchodilator inhalers and switch to dry powder inhalers where clinically appropriate; uptake of new smart inhalers; and the environmental impact of inhalers.

An improvement plan will be in place following the publication of a toolkit in 2019/20.