§ Baroness Noakesasked Her Majesty's Government:
Whether pulmonary rehabilitation should be available to all patients who suffer from chronic obstructive pulmonary disease; and who would benefit from such treatment; and [HL3541]
What proportion of patients with chronic obstructive pulmonary disease are able to access pulmonary rehabilitation; and [HL3542]
113WAWhether current guidance on the provision of pulmonary rehabilitation is adequate; and [HL3543]
Whether the current funding of pulmonary rehabilitation is adequate. [HL3544]
§ Lord WarnerThe National Institute for Clinical Excellence is currently developing a guideline on the management of chronic obstructive pulmonary disease in primary and secondary care. It is due to publish the guideline in 2004. In January 2003 the Respiratory Alliance published its guidanceBridging the Gap which aims to help primary care trusts to commission and deliver high quality allergy and respiratory care.
A wide range of patients can benefit from pulmonary rehabilitation. These include those with chronic lung diseases such as emphysema, chronic bronchitis, asthma, bronchiectasis, interstitial lung disease, or lung tumours. Most pulmonary rehabilitation programmes include medical management, education, emotional support, exercise, breathing retraining, and nutritional counselling. The objective is to help people to gain the highest level of function and independence possible, and to improve overall quality of life. Local British Lung Foundation Breathe Easy groups often reinforce pulmonary rehabilitation programmes. There is now research evidence showing pulmonary rehabilitation programmes improve quality of life and reduce hospital admissions.
Information is not held centrally regarding the proportion of people with chronic obstructive pulmonary disease who can access pulmonary rehabilitation. However, a recent survey by the British Lung Foundation and British Thoracic Society found that 160 out of 266 hospitals across the country provide some form of pulmonary rehabilitation to lung patients.
Substantial new investment in both health and social care services were announced in the 2002 Budget. This amounts to the largest sustained increase in funding of any five-year period in the history of the National Health Service. Over the years 2003–04 to 2007–08, these plans mean that expenditure on the NHS in England will increase on average by 7.4 per cent a year over and above inflation a total increase over the period of 43 per cent in real terms. This means that over the same five-year period, there will be an increase of £34 billion.
It is the role of strategic health authorities, in partnership with primary care trusts, to decide what services to provide for their populations, including those with respiratory conditions. They are best placed to understand local health needs and commission services to meet them.