As we head deeper into winter and emergency hospital admissions rise for people with lung conditions, the charity says many of these could be avoided with earlier diagnosis of hidden breathing conditions.
They are urgently calling for the establishment of easily accessible respiratory diagnostic hubs across Northern Ireland. These diagnostic hubs should be designed to serve the local population and offer testing to help diagnose a variety of respiratory conditions. They should use a “one-stop shop” approach, with people tested, diagnosed and referred, in a single, streamlined service.
As many as 26,000 people in Northern Ireland are misdiagnosed with asthma, costing an estimated £4.5 million every year.1
The diagnostic hubs will not only save the Health Trust’s money, but will also help someone get the correct diagnosis and treatment for their lung condition as quickly as possible, helping to prevent subsequent health issues.
For example, breathlessness brought on by lung conditions such as Chronic Obstructive Pulmonary Disease (COPD) or asthma, can mean people stop being as active, becoming more prone to other medical problems, such as high blood pressure, heart disease, obesity and diabetes.
There can be additional harm caused by inappropriate prescribing, which is costly for the Trust’s, providing medication that is not needed or worsening symptoms. Indeed, late diagnosis results in a 16% increase in direct costs per person over the two years following a COPD diagnosis.2
Analysis by PwC in Asthma + Lung UK NI’s ‘Saving Your Breath’ report found an uptake in spirometry testing in primary care to just 40% of eligible patients would result in £1.7 million in direct cost savings in reduced COPD exacerbations, a reduction of 1,778 hospital bed days of which 605 would be winter bed days saved3.
The report also found that if fractional exhaled nitric oxide (FeNO), a test that measures the levels of nitric oxide in your breath, were made available to all GPs, its use could save £3.4 million through optimising asthma treatment.3
Last year the former Health Minister visited the Moy Health Centre to see the pilot diagnostic hub that the Armagh and Dungannon GP Federation had funded. The hub reduced waiting times for spirometry from 91 weeks to 12 weeks, with most patients going on to be treated in primary case. Rolling this model out across Northern Ireland would be transformation, so Asthma + Lung UK NI is calling on the Department of Health to fund the roll out.
Rebecca Boyle, from Antrim lost her dad Billy aged 72 to COPD in 2018, she said;
“He was diagnosed around ten years before he passed away. Initially, we weren’t bothered by it. We had no idea what it was and because the doctor didn’t seem too concerned or didn’t send him home with lots of medication or information, we just didn’t think about it.
“It wasn’t until several years after my dad was diagnosed that he started going to have his lungs checked at his GP on a yearly basis.
“He was called for pulmonary rehabilitation around 8 years after he was diagnosed but by that point it was too late, and he wasn’t able to do it.
“No one ever explained to us that my dad was terminal or how the disease would progress. There needs to be a lot more awareness of COPD. We had no idea that the disease would kill my dad.
“Watching someone you love gasping desperately for air every minute of the day was traumatic. It made you feel powerless, and we didn’t understand how difficult it was for him and only realised in hindsight which leaves us with a lot of guilt.
“I hope sharing my dad’s story will help other families and raise awareness of the disease. More needs to be done to support people with lung conditions, there must be a better way."
Joseph Carter, Head of Asthma + Lung NI said;
“People in Northern Ireland simply aren’t getting vital diagnostic tests. This creates a barrier to accessing the care and support that is crucial to slowing down lung damage and reducing life-threatening exacerbations and hospital admissions.
“As Northern Ireland heads into winter, A+E departments are filling up with people struggling to breathe. Many of these emergency admissions could be avoided with earlier diagnosis of hidden breathing conditions.
“Our new report, Early Detection, Better Outcomes: Neighbourhood Respiratory Diagnostics, shows that the new breathlessness hub model offers a solution to rethink respiratory diagnostics. By offering testing to a wider population, neighbourhood ways of working can bring efficient and effective services closer to people with lung conditions when they need it.
“The most cost-effective location to deliver diagnostic tests is in the community, closer to people’s homes; something of particular value for people with lung conditions from rural communities, for those that have a disability or illness, or those without the ability to travel easily.”
To read Early Detection, Better Outcomes: Neighbourhood Respiratory Diagnostics report go here.
ENDS
REFERENCE
- Asthma + Lung UK. 2023. Investing in breath – technical report. Accessed here.
- Impact of COPD diagnosis timing on clinical and economic outcomes: the ARCTIC observational cohort study - PMC
3. Saving Your Breath: How better lung health benefits all of us in Northern Ireland. Asthma + Lung NI. 2024. Accessed here.