NHS England guidance aims to achieve earlier diagnoses of COPD, asthma and heart failure

GIRFT has supported NHS England in developing new guidance which aims to enhance GP direct access to diagnostic tests for patients with clinical features of suspected chronic obstructive pulmonary disease (COPD), asthma or heart failure.

The tests are:


By aiming to achieve the earlier diagnosis of these conditions, it is hoped the guidance offers an opportunity to mitigate winter pressures.

Critically, the guidance supports the restoration of local spirometry services, where needed. It also makes additional spirometry capacity available via Community Diagnostic Centres (CDCs).

General practice is also being encouraged to use NT-proBNP blood tests as a triage for echocardiography, in line with NICE Guidelines. This is to ensure that higher-risk heart failure patients get faster access to echo tests.

When implemented effectively, the guidance will:

  • achieve the earlier detection and diagnosis of COPD and asthma, enabling early interventions for optimal treatment, better management of the conditions and benefits to the health system. Earlier detection can also lead to a reduction in acute admissions, reduction in non-elective winter admissions, resource utilisation, improvement in quality of life and healthy life expectancy.
  • achieve the earlier detection and diagnosis of heart failure, enabling referral for specialist assessment and echo in non-acute symptomatic patients, more effective use of echo capacity and providing faster access to echo tests for acute heart failure patients.

As well as the NHS England website, the guidance is also available on the GP Direct Access FutureNHS page.

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