Lung health has a ‘bright future’, according to the British Thoracic Society (BTS), which issued a statement on 27 November to coincide with the opening day of its Winter Meeting in London.

The BTS warned that better days lie ahead if the government, system leaders and stakeholders work together and remain focused on reform.

Representing 4,500 UK-based respiratory specialists, including many physiotherapists, the BTS said it was determined make the ‘vision a reality’ by ‘championing the role of the healthcare workforce and engaging with partners to ensure every step brings us closer to better lung health for all’.

Paul Walker, who chairs the BTS, said: ‘The last few years have been extremely challenging for healthcare staff, but we can now see the light heralding improvement rather than simply survival.’

Sarah Woolnough, the King’s Fund chief executive, delivered the Grand Challenge Lecture at the Winter Meeting at the QE11 centre. She painted a potentially bright future for respiratory health, provided all opportunities to create meaningful change over the next decade are embraced.

At the heart of this transformation is prevention, Ms Woolnough stressed, with stronger action needed on clean air, smoking cessation, and tackling cold, damp housing to reduce the burden of respiratory disease on the NHS and protect future generations. Equally important at a system level is the need to improve access to care through investment in diagnostics. Services should focus on high quality data, research and innovation and adopt digital tools to deliver timely, patient-centred care.

Ms Woolnough also argued that for changes to happen, action to address socioeconomic inequalities is critical. Deprivation significantly worsens respiratory outcomes, with those in the most deprived areas over four times more likely to die from chronic obstructive pulmonary disease. Prioritising these measures will ensure advances in care can benefit all communities.

New UK-wide asthma guideline

Meanwhile, the BTS, the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) launched a UK-wide asthma guideline. It recommends that chronic asthma should be diagnosed by healthcare professionals when people first show symptoms by using simple tests.

Clinicians should always prescribe maintenance or combination treatments, which prevent and relieve symptoms, rather than the familiar blue ‘reliever-only’ inhaler, when asthma is first diagnosed.

The guideline recommends that

• healthcare practitioners should offer a low-dose combination of inhaled corticosteroids (ICS) and formoterol to be taken as needed for everyone aged 12 and over with newly diagnosed asthma to reduce inflammation as well as relieve symptoms
• not prescribing short-acting beta2 agonists (SABA), the most widely used blue ‘reliever’ inhaler/medication, without inhaled corticosteroids, to anyone diagnosed with asthma

The independent guideline committee looked at evidence which showed using the combined ICS and formoterol inhalers when required led to people suffering fewer severe asthma attacks.

As part of the final guideline publication, BTS, NICE and SIGN have also developed a new digital resource which will act as a ‘one stop shop’ online. The digital asthma pathway links to tools, resources and information, all stored in a central hub, accessible from each organisation’s website.

Having one clear set of national asthma guidelines is vital to ensure people receive consistent and effective asthma care across the health service, so people across the UK receive the right diagnosis and treatment [Jonathan Benger]

The pathway has been designed to support health professionals in making accurate diagnoses, promoting good practice, and providing effective, personalised treatment to control and prevent acute asthma attacks.

The asthma pathway includes existing BTS/SIGN guidance on management of acute asthma, non-pharmacological management, and occupational asthma. Other resources include a joint patient decision aid on asthma inhalers and climate change, all asthma drugs and treatments recommended by NICE and advice from the Scottish Medicines Consortium.

Professor Jonathan Benger, chief medical officer and interim director of the Centre for Guidelines at NICE, said: ‘Having one clear set of national asthma guidelines is vital to ensure people receive consistent and effective asthma care across the health service, so people across the UK receive the right diagnosis and treatment for them.’

Professor Benger added: ‘‘The guideline also includes new recommendations for the diagnosis of asthma in both adults and children, including the use of FeNO (a simple breath test) and measurement of eosinophil cells in the blood as well as traditional tests like spirometry or peak flow measurements.’

In the UK, about 5.4 million people have asthma, which is about eight people in every 100.

You can read the full asthma: diagnosis, monitoring and chronic asthma management guideline on the NICE website.