From the NCD for Respiratory Disease - Respiratory Clinical Networks and Support Units

Friday, June 18, 2021

Respiratory Clinical Networks and Support Units proved invaluable during the pandemic and represent a shift to more integrated ways of working, for good.


In this blog, Andrew Menzies-Gow, NHS England and NHS Improvement’s National Clinical Director for Respiratory Disease outlines how Respiratory Support Units and Respiratory Clinical Networks were key to the pandemic response and how they’ll continue to play an important role as we look towards the future.

Respiratory teams have been front and centre of the pandemic response, whether managing acute COVID-19 patients or supporting those recovering from the virus, teams have adapted quickly to new ways of working. We have seen how Respiratory Support Units (RSUs) have worked closely with Intensive Care teams to ensure patients receive optimal care in the correct environment. And whilst RSUs already existed, they have really come to the fore during COVID-19 and demonstrated how integrated ways of working have proven effective in saving lives. Earlier this week, guidance was published from the British Thoracic Society and the Intensive Care Society on establishing Respiratory Support Units, which I fully welcome.

Recognising the extraordinary circumstances brought about by COVID-19, in September 2020, NHS England and NHS Improvement accelerated plans to establish 13 Respiratory Clinical Networks across the country.  The Networks bring together leaders from NHS and other health and social care organisations, to transform the diagnosis, treatment and care for respiratory patients in their local area, focusing on reducing health inequalities. 

In my last blog earlier this year, we were in the midst of another wave of COVID-19 and although challenges remain, the progress made in the COVID vaccination drive and the additional £100m funding announced this week for Long COVID, means that the Respiratory Clinical Networks are turning their attention to aid the recovery and restoration of general respiratory services and subsequent delivery of NHS Long Term Plan objectives, learning from innovations that were accelerated during the pandemic.

The importance of early and accurate diagnosis is one of the main Long Term Plan objectives for respiratory and the restoration of spirometry, a test used to help diagnose lung conditions, is paramount. The recent publication of guidance for safely restoring spirometry services in primary care is part of the effort to put this back on track and as part of this restart, we are also providing additional investment to ensure enough staff are trained in the delivery and interpretation of quality assured spirometry.

The other key restoration priority is pulmonary rehabilitation (PR), a programme of exercises and advice to enable better self-management for people with COPD. This is one of the most effective available interventions, which is why the NHS is providing funding to improve the service provision of PR across the country to improve the quality, accessibility and levels of completion.

During the pandemic, we have also seen a plethora of digital innovations introduced and accelerated, such as the use of telemedicine and self-management apps. We are developing a national package of options to support patients to self-manage their lung condition.

And let’s not forget the challenges to our society beyond COVID. We are also facing a climate crisis and I am proud to say that the NHS is the world’s first health system to commit to reaching net zero carbon and with this work brings the opportunity to improve outcomes whilst reducing carbon emissions.

This is only a snapshot of the work that is going on across our national and local teams and Respiratory Networks. In less than a year the networks have not only led the response to COVID-19 but established a new, integrated way of working to create respiratory services that are moulded around the individual and are adaptable to the changing needs of a modern population.