Lack of lung testing and long waiting lists create a 'perfect storm' for NHS Wales this winter

Asthma + Lung UK Cymru launch a new report revealing that people with lung conditions are trapped in a vicious circle of late diagnosis, have limited access to vital treatments, and poor support to manage their conditions

A new report launched today, ‘Saving your breath: how better lung health benefits us all in Wales’ outlines recommendations that, if adopted, could offer relief to people affected by lung conditions, deliver massive savings and reduce pressure on NHS Wales at a time when health boards are being asked to find savings in their budgets. These recommendations include ensuring diagnostic tests are funded, improving access to the right treatments such as pulmonary rehabilitation (PR), and providing people the support they need to manage their lung condition to keep them well and out of hospital.

Using economic modelling by PwC, the report reveals that asthma and COPD cost NHS Wales over £295 million each year and have an overall impact of £772 million on the Welsh economy1. Lung conditions are one of the leading causes of winter pressures on the NHS, as people with these conditions are more vulnerable to respiratory viruses, including flu and COVID, and colder temperatures.

The analysis commissioned by Asthma + Lung UK Cymru says that despite lung conditions being the third biggest killer in Wales2, simple diagnostic tests for common lung conditions aren’t widely available to GPs, creating delays and leading to misdiagnosis.  The charity is now calling for all health boards to urgently restart spirometry in all parts of Wales and says fully funded diagnostic testing would result in over £3 million in direct NHS cost savings related to reduced exacerbations, with this achieved by patients receiving an accurate diagnosis and then given appropriate treatment.3

One of those treatments is PR which is a well-evidenced and high value physical exercise and education programme, which helps keep people’s lungs healthy. The analysis highlights the expansion of PR in Wales would result in £7.7 million of direct NHS savings related to reduced exacerbations, as well as a reduction of 10,500 bed days, 3,500 of which would be saved over the winter period.4

But current access to PR in Wales is limited, patchy and being held back by workforce shortages. Hywel Dda, Cardiff and Vale, and Betsi Cadwaladr UHBs are reporting the highest waiting lists between 2 and 3 years.5 These waiting lists are failing people with lung conditions and holding them back from leading a happier, healthier, and longer life.

This year the Welsh Government announced £30m of investment in community care to reduce pressure on hospitals.6 If properly implemented, Asthma + Lung UK Cymru’s recommendations would save significantly more than £19.5 million a year and free up just under 14,000 bed days, 5,000 of which would be during the winter period7


Trystan Roberts, 47, from Powys said being diagnosed with asthma and COPD was a huge shock. He explains:

“I’m an ex-smoker but never had any issues with my breathing. In 2007 I had a chest infection; it was so bad I was hospitalised and put on oxygen. While admitted things took a turn for the worse and I contracted pneumonia. It was then when I experienced my first ever asthma attack. 5 days of care and left hospital with an asthma diagnosis. It was a huge shock!

“One minute I’m fine and the next I can’t even lift something without gasping for air. I was given medication after medication without any real answers. It was frustrating.

“I struggled with my breathing for around 7 years before also being diagnosed with COPD.  A nurse recommended pulmonary rehab; I had no idea what it was so took to YouTube to find out what it was. I was sceptical as I thought, exercise would make me worse as I struggle to breathe doing the simplest of tasks.

“Due to the pandemic I had to wait 2 years for the course to restart. It was then done virtually which was great as I work night shifts. It really boosted my confidence and felt my health definitely improved. To think in some parts of Wales, people are currently waiting up to 3 years is a travesty.

“When you have lung conditions like mine, your health can change so quickly so waiting that long for treatment is not acceptable. People need help sooner to help keep them out of hospital.


Joseph Carter, Head of Asthma + Lung UK Cymru, said:

“Winter is the deadliest season for people with lung conditions and diagnostic tests hold the key to giving someone an accurate diagnosis. Without these tests, many are missing out on the treatments they desperately need to live and stay well at home. People with lung conditions deserve better.”

“It’s a year since the new Quality Statement for Respiratory Disease was published and extraordinarily little progress has been made to implement it. Whilst the Cancer Quality Statement was supported by an Improvement Plan with clear measurable outcomes, the Welsh Government have refused to do the same for lung health. People living with a lung condition cannot afford to lose another year to inaction.

“There are huge savings to be made by improving the diagnosis and treatment of lung conditions such as asthma and COPD, in terms of direct NHS savings, including reducing hospital bed days. It doesn’t make sense that lung conditions aren’t given the same priority as other big killers such as heart disease.”

Read the full report: Saving Your Breath: How better lung health benefits us all of us in Wales | Asthma + Lung UK (


Notes to Editors  

For further information, please contact: Stephanie Woodland, Communications Officer, Asthma + Lung UK Cymru on 07549049923 

Asthma + Lung UK Cymru is the only charity in Wales fighting for everyone with a lung condition, aiming for a world where everyone can breathe with healthy lungs. We fund research. We provide advice and support for the 1 in 5 people who will get a lung condition during their lifetime. We campaign for clean air and for better NHS diagnosis and treatment.


1: Saving Your Breath: How better lung health benefits all of us in Wales. Asthma + Lung UK. 2023. Available here.

2: Data via NOMIS for 2019. Chronic Lower Respiratory diseases, pneumonia and flu are 12.1% of deaths in Wales – the third leading cause behind cancer and heart disease. Data accessed here.

3: Saving Your Breath: How better lung health benefits all of us in Wales. Asthma + Lung UK. 2023. Available here.

4: Saving Your Breath: How better lung health benefits all of us in Wales. Asthma + Lung UK. 2023. Available here.

5: Pulmonary Rehabilitation – Mapping current services – November 2022

6: Up to £30m investment in community care to reduce pressure on hospitals | GOV.WALES