I beg to move,
That this House has considered World COPD Day.
It is a pleasure to serve under your chairship, Mr Efford. I thank the Backbench Business Committee for making time for this debate. I am always pleased to see the Minister in her place—she knows that—and we look forward to her answers to our requests on behalf of our constituents. I am also pleased to have other colleagues here, including the shadow Ministers for the Conservatives and for the Lib Dems, the hon. Members for Farnham and Bordon (Gregory Stafford) and for North Shropshire (Helen Morgan), and also my good friend, the hon. Member for Surrey Heath (Dr Pinkerton).
I am glad to be able to raise the issue of chronic obstructive pulmonary disease. Yesterday was World COPD Day, so I pay tribute to the wonderful work carried out by so many organisations and individuals to draw attention to the illness. We had an event here last night, which was well attended. The people in the Gallery are those who do the hard work for the all-party parliamentary group for respiratory health, which I chair. We had a great event last night with many excellent speakers.
I want to reflect on the organisations and individuals that attended last night to draw attention to the illness. Hugh McKinney is going to look at me and say, “You mentioned that lady again”, because last night one of our special guests was Shirley Ballas of “Strictly Come Dancing”. I could not dance if my life depended on it—I have two left feet—but that lady can. Last night she was not there because she is a judge on “Strictly Come Dancing”. She was there to tell the story of how she cares for and looks after her mum, who has COPD. There are two sides to the lady—the side we see on TV and the caring side. The previous debate was about unpaid carers across the United Kingdom, in all constituencies, and the work that they do. It was a pleasure to take part in that debate and to see so many there.
As chair of the APPG for respiratory health, I will cover a number of issues today around COPD. I will frame my comments around the latest initiatives and also the current policy direction. Hopefully we can try to marry those two together so that we can have a focus and a target to do better. To make that happen, of course, we need Government and ministerial support.
As always, I am indebted to Sarah Sleet and her wonderful team at Asthma and Lung UK for their outstanding help and ongoing support. Without their enormous help to me and the APPG that I chair, we just could not manage as well as we do. I also want to say a special thanks to Jonathan Fuld, the national clinical director for respiratory disease, for his expert advice and counsel. I pay tribute to the ongoing work of our expert stakeholder groups, which comprise senior clinicians, industry, professional bodies and other experts. We have Zoom meetings because that is the best way for us to come together from all over the United Kingdom and it means people do not have to travel. When we have our Zoom meetings we have fantastic contributions from all over the United Kingdom of Great Britain and Northern Ireland, and sometimes further afield.
I want to begin with a general point on the modern service frameworks. There is much to be thankful for in what the Government are doing and we want to focus on that as well, but there are also things that we want to ask for. Although the APPG warmly welcomed the initiative of the modern service frameworks, the Minister will not be surprised that we were disappointed that respiratory health was not included in the first wave. Respiratory health is an ideal candidate, I believe, as do others inside and outside the Chamber, for the next wave. What can the Minister do to include respiratory health in the next wave of the Government’s 10-year plan for health, which we very much welcome and are encouraged by?
The outcomes of COPD are widespread and have a huge impact on the NHS. I will give some statistics to show that. Sometimes, people hear statistics and are sceptical. I always think about “lies, damned lies, and statistics”, but the stats are important because they set the scene. Many times when we are looking at the objectives and targets for the NHS, we need the statistics before us, because they indicate the policies that hopefully the Government will follow.
Lung conditions, including COPD, are the largest cause of emergency hospital admissions, especially in winter, when respiratory admissions can increase by some 80%. These figures are worrying; we are in that season now, and we could see that figure. The rate of emergency admissions to hospital for COPD in England increased by 9% in 2024 compared with 2023; unfortunately, they are increasing consistently. That represents some 121,129 A&E admissions—significantly higher than in the previous year. Worryingly, the trends are upwards. I hope that the Minister, when she responds to the debate, can give us some ideas about how the Government can reverse those trends and reduce that figure.
COPD is the second most common cause of emergency admission in the United Kingdom, and 1.7 million people in the UK have been diagnosed with it. In my office, when we meet constituents, we help them with their benefits forms and try to put them on the pathway to get some help to deal with their health conditions. I have known many people over the years who, unfortunately, are no longer here today because COPD has taken their life. Others are on oxygen, just trying to survive every day. Again, that is quite worrying.
It has been estimated that there could be around 600,000 more people in the UK who are living with undiagnosed and untreated COPD. What can we do to identify those people and ensure that they understand what is happening to them, so they can get some help with the life that they will now lead? Lost productivity due to COPD is estimated to cost around £1.7 billion per year. There is a cost to every disease, but there is a real cost to this disease, and if we can diagnose and catch it earlier, perhaps we can reduce that sum.
My last point is about something quite worrying. Each year, around 30,000 people in the UK die from COPD. That is the reality experienced by some of my constituents I have met over the years, but who are no longer with us. The disease progresses so fast that people’s life expectancy is reduced. Deaths caused by respiratory diseases are more strongly linked to deprivation than deaths caused by any other major disease. People living in the poorest areas of the United Kingdom are five times more likely to die from COPD than those living in the richest areas. That is a real disparity, whereby people in deprived areas are more susceptible to COPD and their life expectancy is also reduced. I have another ask of the Minister: how can the Government address deprivation and its impact on particular areas, specifically when it comes to COPD?
Research from Asthma and Lung UK shows that someone from the poorest 10% of households is over two and a half times more likely to have COPD than someone from the most affluent 10% of households. That is a real disparity. If someone lives in an affluent area, they have 10% less chance of getting COPD than someone living in a deprived area.
We hope that the transition from hospital to community under the 10-year plan for the NHS will transform COPD outcomes in the most deprived areas. A survey by Asthma and Lung UK found that almost a quarter of people with COPD wait five years or more for a diagnosis, with one in eight of people with COPD waiting for over 10 years. Again, I have another ask of the Minister. How can we shorten the wait for a diagnosis of COPD? If we catch it earlier, we can reduce the impact on life expectancy and help with life conditions and how to reach a better level of care.
The same survey showed that only 9% of people with COPD in the UK were receiving good basic care. That is worrying. Again, as chair of the respiratory health APPG, it is one of the things that we hope to address. While the statistics are stark, the APPG also acknowledges and welcomes a huge amount of work undertaken by NHS England ahead of the winter months to relieve the pressure on the NHS. We are all here to make lives better, and not to make them worse, but sometimes we need to have a better idea of what needs to be done. The NHS can do much, but it cannot perform miracles. It can only do the best it can, so how do we help it to do so, given all the pressures it is under?
We commend the urgent and emergency care delivery plan, and Exercise Aegis, which will devolve accountability for winter readiness to the integrated care boards—probably a good idea. Under Aegis, NHS England will stress test winter preparedness by running seven regionally-led exercises. I ask the Minister for some detail on that, on what it means and how it will work—no doubt we are to hear that shortly. The initiative is welcome and a well thought-out plan, I believe—I am sure others will comment —that promises to deliver the regional outcomes that will make a huge difference. Only in the past few days have we realised that winter is coming—anyone who has not felt the cold must be wearing a strong and heavy coat—so will the Minister update us on the outcomes of the regional exercises and how they feed into the winter preparedness strategy?
We are busy in the APPG—Hugh and the team clearly do that for us—and recently we held a roundtable on the winter pressures in partnership with the Centre for Applied Respiratory Research Innovation and Impact—CARRii, to abbreviate all those words—which gave an outstanding presentation. Early next year, we will produce a short report, taking the outcomes of that meeting and the data from this year into account. We are happy to share it with the Minister, because I think it will be helpful when drawing up a better way to do things.
Key themes of the roundtable included an increase in vaccination rates—more focus on that has been because of, unfortunately, a slight reluctance to take up vaccination —and how we encourage that. At the Tuesday morning roundtable, with Lord Bethell from the other place, we had an opportunity to discuss how best to do that with those in the NHS, and with other companies and people who have a deep interest in the subject matter. Some of the ideas will be helpful for the future.
We need better infection control. COPD exacerbations are mainly driven by infections. How can we address and target that in the system? We must implement fully the five fundamentals of COPD care by the National Institute for Health and Care Excellence, which outline what effective management of care looks like, such as vaccination, smoking cessation and pulmonary rehabilitation. Recent analysis has found that expanding access to PR services to all eligible patients could result in £142.6 million of direct NHS savings related to reduced exacerbations, as well as a reduction of 194,000 bed days, 66,000 of which would be saved over the winter period.
Those figures cannot be ignored—at the end of the day, the NHS has to work within the figures, the money, it has available. When we look at the savings and the reduction in bed days, in particular over the winter period, we must try to do better. The final fundamentals are personalising self-management planning and optimising treatment for co-morbidities. Will the Minister please assure us that the NICE fundamentals of COPD care are being implemented consistently across the country? The Minister will know, because she is very knowledgeable and responsive to these issues, that the APPG strongly supports the 10-year plan and the three shifts, which are ideally placed to transform respiratory care and outcomes. Community delivery, especially, promises a great deal for improved respiratory outcomes by placing facilities closer to home. That is a better way to do it.
We welcome the work already under way to place respiratory services in community settings and the introduction of spirometry in all CDCs and community health services. This a really positive way forward. There is, however, evidence to suggest that not all patients receive spirometry tests. If we are going to introduce spirometry, we need to ensure that all patients can receive those tests. Will the Minister make sure that these tests be undertaken on all eligible patients?
Will the Minister also please look at the waiting lists for diagnostic testing and see whether they can be prioritised to test those at the highest risk first? That is a lot of asks—I have given the Minister and the shadow Minister a copy of my speech, so hopefully the Minister had all my questions in advance. I hate to throw around 20-odd questions at her in the space of an hour and a half and expect answers right away, but hopefully we can get those answers—I know that the civil servants who are here will work very hard to ensure that happens. Although it might be too late for this winter, perhaps that provision could be in place for people for next year.
We are also looking forward to the upcoming NICE guidance on the biologic therapies for COPD, which will be a complicated process. We will keep an eye on the implementation of these drugs when they are approved. The advancements in medicine cannot be ignored; it is really good to have them, and it is encouraging that we are living that bit longer now. We can now extend and improve the lives of people with diseases that would previously have killed them fairly young.
Finally, we have been looking at the incidental findings from lung cancer health checks. According to recent data, around 100,000 people who have been assessed under the targeted lung health check programme have been diagnosed with emphysema or symptoms of no recognised disease to date. What can be done to help those 100,000 and perhaps others facing those circumstances who have not yet been diagnosed?
Lastly, there is no onward referral from the lung health checks, and I think there should be. It would be helpful to have an assurance about how that could be achieved. I know that this is a complex area—it always is—and that lung cancer health checks are carefully targeted, particularly for those in our most deprived communities, who are least likely to be well served, but this provision would seem to fit perfectly in a modern service framework for respiratory health. So, I end where I began: I hope that this will happen sooner rather than later. I have made a lot of requests, but we are fortunate to have a Minister who responds in a way that gives us all encouragement. We have a real problem with COPD, and this debate gives us the chance to highlight the issue for patients. The winter pressures are on. I am pleased to see my friend, the hon. Member for Blaydon and Consett (Liz Twist). She is the co-chair of the APPG, and she will hopefully speak next. I look forward to hearing all the contributions, including from the shadow Minister, the hon. Member for Farnham and Bordon, and, ultimately, the Minister.