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Letters to the Editor
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COPD
Give COPD the priority it deserves
From Mr P. Jerram, MRPharmS,
and Ms S. Kearney
Chronic obstructive pulmonary disease (COPD) is a major drain on NHS
reaources. It was responsible for 1,152,023 bed days in England in 2005
(when these patients were the third largest group of bed users). It is
currently the fourth biggest killer in the UK and it is predicted that
by 2020 it will be third in the leading world-wide cause of death from
chronic disease.
There are two key changes occurring in the NHS in England that make the
management of COPD more important than ever before: payment by results
(PBR) and practice-based commissioning (PBC). PBR is a new finance system
for paying hospitals that was first introduced in England in 2003 and
was greatly expanded in April 2006. It is important for primary care
because it makes it possible for primary care trusts and GPs to disinvest
from hospitals for the first time; if a patient is not admitted, the
GP does not pay the hospital. Under the old financial system it was extremely
difficult to do this.
PBC, where clusters of GP practices opt to hold the budget for prescribing
and hospital care, was first introduced in April 2005 and now nearly
90 per cent of GP practices are involved. PBC is important because GP
clusters that save money on their budgets can reinvest these savings
into additional patient care.
The Health Care Commission report on COPD in June 2006 said that a good
deal more could be done to diagnose and effectively treat COPD. Furthermore
the Department of Health announced that it was commissioning a national
service framework for COPD, although this is not due for publication
until 2008.
We believe that now is the time to work with colleagues to ensure COPD
is given the priority long since afforded to cardiovascular and mental
illness and that PBR and PBC offer the levers to make this happen.
Paul Jerram
Head of Medicines Management
Sarah Kearney
Respiratory Nurse Specialist
Isle of Wight Primary Care Trust
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The
Pharmaceutical Journal