From the NCD for Respiratory Disease - Progress of the NHS Long Term Plan in 2020

Monday, March 1, 2021

Professor Andrew Menzies-Gow, NHS England’s national clinical director for respiratory disease, explains how the NHS has been working to help those with lung disease throughout the pandemic.

The pandemic has had a profound impact on the day-to-day lives of people across England, and it’s difficult to over-emphasise how extremely challenging it has been for people living with lung conditions as well as those contracting COVID-19 and experiencing ‘long COVID’.

In response, there had to be some temporary pausing and reallocation of NHS England’s planning and delivery capacity in order to focus on establishing a national and local response to COVID-19.

Fortunately, by the Autumn each of our programmes of work resumed in full to progress both the work of the NHS Long Term Plan and the new COVID-19 workstream. Against this difficult background, it has been fundamental that respiratory disease continues to be a clinical priority as outlined within the LTP. This has been the driving force behind a shift in momentum, with more focused activity on how to organise and integrate the resources and staff working in respiratory care across primary, secondary and community services.

I am particularly encouraged that in 2020 we have seen each Sustainability and Transformation Partnership (STP) developing their plans, setting out the improvements they would make in local and regional respiratory care; local areas are now in a position to tackle the challenges that have existed for some time.

In other good news, NHS England and NHS Improvement established the new Respiratory Clinical Networks in September 2020, which bring a range of exciting opportunities. By supporting the timely sharing of intelligence and good practice, the networks will help accelerate the delivery of integrated respiratory services, and a new pathway will be introduced to support a more seamless experience for patients across different settings and services. The networks will also support the acute management and ensure appropriate follow up of COVID-19 patients as well as planning for any future surges.

Alongside these new developments, a key priority is the restoration of respiratory services based on the NHS Long Term Plan priorities:  early and accurate diagnosis, medicines optimisations, community acquired pneumonia and pulmonary rehabilitation. Each of these programmes are working hard to adapt to the COVID-19 environment.

This has seen unmatched innovation in service delivery, with new ways of working including online and remote appointments that ensure respiratory patients are still able to get the care they need without leaving their home, while also keeping people safe.

We have also seen increased understanding among healthcare professionals of the benefits of patients taking greater personal responsibility for their own health and wellbeing. This is an important shift which I want to see continuing, with more awareness and resources allocated to support self-management.

There have been other encouraging behaviour changes with long-term health benefits in 2020, including an increase in the number of people who have stopped smoking and an increase in the flu vaccination uptake. I hope these trends will continue in 2021 and beyond.

This year we have also seen some targeted interventions to reduce health inequalities, as we saw disparities in respiratory disease being echoed by significant disparities in the impact, and death rate of COVID-19. More focused activity is being developed in 2021 for areas of high deprivation, lower socioeconomic groups and for people with complex health needs.

We’re now in the midst of another wave of COVID-19 and I would like to extend my huge thanks to the frontline respiratory healthcare professionals who continue to show such extraordinary commitment to deliver care to people living with lung disease and COVID-19 patients.

As we head into 2021 I am committed to ensuring we restore the work of the NHS Long Term Plan in order to deliver important service changes now and into the future.