Why tackling lung disease needs to be top of the new NHS England CEO’s to do list

Sarah Woolnough, CEO of Asthma UK and the British Lung Foundation, explains why the new chief executive of NHS England, Amanda Pritchard, should be tackling lung disease as a priority.

Last week, it was confirmed that Amanda Pritchard will take over from Simon Stevens as chief executive of NHS England. Amanda has worked as Chief Operating Officer at NHS England and previously as chief executive of Guy’s and St Thomas’ hospital trust in London, so she will be well aware of the challenges the health service is facing.

I want to take this opportunity to congratulate Amanda on her new role. There couldn’t be a more important time to take over running the health service that we all rely on and benefit from.

Leading the NHS involves an almost impossible balance of responsibilities and priorities. Amanda will not be short of advice from patient charities, professional bodies and think tanks, but here are the areas that we at Asthma UK and the British Lung Foundation hope she will focus on.

1 in 5 of us will be affected by lung disease during our lives

Respiratory illness costs the UK £9.9 billion each year, yet we still have some of the worst outcomes in Europe. For many years, respiratory health has been under-prioritised, with patients left facing late diagnosis and poor treatment options.

However, we have turned a corner in recent years. The NHS Long Term Plan makes respiratory a clinical priority for the first time ever. That means there is now a programme of work - with funding - aiming to improve diagnosis, open up access to physical rehabilitation, ensure everyone has the right medication and that all people with lung conditions are supported to manage their own health. This represents a huge step forward.

The COVID-19 pandemic has meant that much of this work has been delayed. Face to face services have been on hold and NHS staff have of course been under too much pressure to deliver new programmes. As we move beyond the pandemic, I hope Amanda’s first priority will be to get delivery of the NHS Long Term Plan back on track. It will be a long road to recovery in the NHS, but we must ensure that we fulfil the early promise of the plan and keep pushing for better care and treatment for lung disease.

Tackling health inequalities

The second area I hope she will focus on is health inequalities. Awareness of the huge disparities that exist in outcomes across the country and between groups of people has been growing for some time. Lung disease is particularly affected – people living in the most deprived areas of the country are more than twice as likely to die from lung disease than those in the richest. Lung disease rates are greatest in places with high numbers of people smoking, poor air quality or an industrial heritage.

We cannot address lung disease without tackling these inequalities. The causative factors of lung disease will continue to affect the worst off, and as a result we will only see the gap between rich and poor grow further. The good news is there are clear solutions to this. Amanda will be well placed to work with the government to put these in place.

Learning from the pandemic

Finally, it is essential that the NHS learns lessons from the pandemic. Health services have had to put innovative solutions in place to keep delivering care – from remote consultations for lower risk patients to home administration of drugs for severe asthma, the landscape looks very different these days. It will be essential to evaluate these changes and decide what is really working for patients and should be kept.

At the same time, COVID-19 has meant we are all more aware than ever of lung health. The huge success of the vaccination programme can show us a new way forward for driving uptake of the annual flu jab, so essential to keep people with lung disease out of hospital. And the value of training and recruiting respiratory specialist health care professionals has been proven beyond all doubt. Amanda will need to make sure that these learnings are used to plan for the future.

The new chief executive will have a very long to-do list but I hope these are useful suggestions for where to prioritise. At Asthma UK and the British Lung Foundation, we stand ready to work with NHS England in any way we can to improve outcomes and quality of life for everyone with a lung condition.

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