Charity calls for patient re-testing amid fears over asthma and COPD misdiagnosis

PATIENTS in West Somerset aged 35 years and older and who have asthma or the progressive illness chronic obstructive pulmonary disease (COPD) should be re-tested, according to a leading charity.
The British Lung Foundation is calling for the re-testing following evidence of confusion over diagnosis and treatment of the two respiratory diseases.
A nationwide survey of 776 GPs carried out for the charity by Doctors.net.uk revealed more than three-quarters of doctors in the Westcountry found it challenging to differentiate between asthma or COPD, causing misdiagnosis and distress among patients.
Other survey findings of Westcountry GPs showed:

• Five per cent of GP practices lacked appropriately trained staff to carry out spirometry testing
  
• Less than a third (31 per cent) of GPs were trained to carry out spirometry testing themselves
  
• The Westcountry had the highest percentage of GPs, at more than one-quarter (28 per cent), who said there had been no change in the quality of COPD diagnosis under the QOF system
  
• Less than two-fifths (39 per cent) of GPs said the QOF system should reward GPs for clarifying whether a patient has asthma or COPD

A separate UK-wide patient survey carried out by the charity showed that nearly two-fifths (39 per cent) had been told they had both asthma and COPD, a far higher figure than should be the case.
The BLF said it was vital a diagnosis of COPD or asthma was clarified and that the GP contract should reward this next year.
BLF spokesman Dr Keith Prowse said: “It can be difficult to differentiate between an asthma and COPD diagnosis but the long-term aims of asthma and COPD treatment are different, and it is vital that people with either disease have an accurate diagnosis.
“In asthma, the aim is to restore full lung function and if it is not treated properly the inflammation can cause scarring in the lungs and permanent damage.
“In COPD, the management of the disease is quite complex and treatments such as pulmonary rehabilitation are crucial.”
BLF chief executive Dame Helena Shovelton said: “Patients get understandably distressed and angry when they realise they have been misdiagnosed and not given the most appropriate treatment.
“We are calling for everybody age over 35 with an asthma or COPD diagnosis to be re-tested, and for this to be made part of the GP contract next year.”
COPD is the umbrella term for a number of lung conditions including chronic bronchitis and emphysema.
It is a progressive, irreversible lung disease which kills more people every year than breast, bowel, or prostate cancer, and is both preventable and treatable.
Early diagnosis and appropriate treatment can slow the progression of the illness.
Dame Helena said: “The UK faces a chronic lung disease time bomb.
“COPD is already the fifth biggest killer in the UK and it is the only major cause of death whose incidence is on the increase.
“COPD is caused by smoking or by exposure to environmental pollution and to hazards at work such as dust, fumes, and gases.
“In a very small number of people it is caused by a genetic deficiency.”
The British Lung Foundation is the only UK charity working for everybody affected by lung disease, including COPD.
It provides support via a telephone helpline, booklets on lung diseases and related issues, a comprehensive website, BLF community nurses, and a Breathe Easy support network for anybody affected by lung disease.
The charity’s helpline can be contacted on 08458 50 50 20 or by visiting the website http://www.lunguk.org/.

• Our photograph shows BLF celebrity supporter,Olympic gold medalist rower James Cracknell. Photo submitted.

LETTER: Nominate GPs for award for supporting carers

Dear Editor - Looking after a loved one who is sick, disabled, or frail is not easy – it can be physically hard, emotionally draining, and very isolating.
In a recent study, 74 per cent of unpaid family carers in the South West say that their health and well-being is worse off as a result of caring.
Often, the person that carers turn to for support is their GP.
This support can vary greatly from practice to practice and yet it can make all the difference to carers.
The Simplyhealth Caring Awards (in partnership with The Princess Royal Trust for Carers) are looking to celebrate all the good work being done throughout the UK today to support carers.
I would like to draw your readers’ attention specifically to the Simplyhealth Carers’ Choice Award that looks to recognise all the fantastic work being carried out by individual GPs.
Carers in West Somerset, Taunton Deane, and Sedgemoor can now say ‘thank you’ by nominating their GP for this award.
This year’s prize is £250 each for the winning GP and for you.
To nominate, all you need to do is write a letter about how your GP supports you as a carer.
It is very important to focus on the support they give to you, not just the person you care for.
Please e-mail gpawards@carers.org or write to The Princess Royal Trust for Carers, Freepost RRRY-JLXK-GZCG, Unit 14, Bourne Court, Southend Road, Woodford Green, IG8 8HD.
You need to remember to include contact details for both yourselves and your GP.
The closing date for all the awards is October 10, and more information can be found on www.carers.org.
The winners will be announced at an event in November.
Sheila Hancock
Actress and author

Breast cancer hot spot fears are allayed

FEARS that Minehead was becoming a hot spot for breast cancer cases among women have been allayed.
Figures given to The Post showed there had been 18 cases diagnosed in a 14-week period from October, 2007, to the end of the year.
Compared with a national figures which indicated for a town the size of Minehead there should be just 8.7 per year, it seemed there had been a dramatic rise.
The figures were collected from a mobile screening unit which visited the town from October to January of this year, and a local GP surgery.
But Dr Julia Verne, director of the South West Public Health Observatory, said: “This recent increase in the detection of breast cancer for women living in and around Minehead is entirely expected and due to the effectiveness of the mobile breast screening service.
“However, I do appreciate how people may mistakenly jump to the conclusion that there has been a sudden increase in breast cancer when they hear of increased numbers of cases.
“It does not indicate an unusual or higher than expected rise in the disease.
“The same effect occurs whenever the mobile breast screening service visits an area and occurred back in 2004 when the mobile screening service last visited Minehead.
“Breast screening has been shown to save lives. The mobile breast screening service is able to detect breast cancers which women may not be able to detect themselves.
“Early detection and treatment results in the best outcome for the small number of women who may be affected by the disease and I would therefore strongly recommend that all women take up the invitation to be screened when they receive an invitation letter.
“Women who identify a lump in their breast or be concerned about any breast abnormality should make an appointment with their GP to discuss their concerns.”
Dr Verne said given that the population was considerably older in Minehead than in other parts of the country a meaningful comparison of average figures could only be made between age-standardised rates of cancer.
Over the last 10 years of available data (1996 to 2005) there were 129 cases of malignant breast cancer in Minehead, which equates to a age-standardised rate of 125 cases per 100 000.
Dr Verne said it was not significantly different (statistically speaking) either from the English age standardised rate - 120.6 cases per 100,000, or from the age standardised rate for Somerset - 136 cases per 100,000, or from the South West of England - 137 cases per 100,000.
The Somerset Breast Cancer Unit is responsible for providing three-yearly breast cancer screening in the area.
In Minehead, this is provided by a mobile screening unit which visits the town for approximately three months every three years.
The last visit happened between October, 2007, and January, 2008, and the previous one in late 2004.
Dr Verne said: “At this point not all women picked up by the latest breast screening visit have undergone all their testing and treatment.
“Therefore, it is not possible to provide a confirmed number of cases.
“Some of these abnormal breast screenings might also prove not to be cancer.
“In 2004 a similar number was detected compared to the recent mobile breast screening service visit.
“In conclusion, we believe that the number of cases of cancer picked up by this screening round is typical for Minehead, and the overall rate of breast cancer is normal for a town with Minehead’s population and demographic composition.”

Hospital cuts waiting lists to 18 weeks

WAITING times for appointments at Musgrove Park Hospital, in Taunton, have significantly reduced - a year ahead of target.
The latest figures show that at the end of December, more than 90 per cent of all patients waited less than 18 weeks from when they were referred by their GP to when their treatment started.
This time included all the necessary steps in a patient’s journey before treatment could be started, such as diagnostic or other tests.
It was an improvement from November, 2006, when fewer than half of all patients were treated within 18 weeks.The hospital’s director of operations, Jon Scott, said: “This is a fantastic achievement.
“We have met the target of reducing waiting a year ahead of schedule.
“Our staff have done extremely well to look at everything they do to reduce unnecessary steps and ensure that different departments and teams work closely together.
“We have introduced more ‘one stop shops’ for patients so they do not have to make a second visit for a test, and we have redesigned services to better meet patients’ need.”
One recent patient in Musgrove’s orthopaedic department, Sheila Rogers, said: “I was brought in incredibly quickly, and in fact the whole thing was no more than about 12 weeks from start to finish.
“As my operation was so minor - a cyst on my toe - I expected to wait for ages, but in fact they offered me an appointment before I was expecting it.
“I was also really impressed that when I went in for my pre-op they gave me a full health MOT.
“People do worry about waiting for hospital treatment and it is great that waiting times at Musgrove Park are now so low.”
Project leader Ian Bramley said: “Achieving 18 weeks is great for the hospital and our patients, but this is only one step towards a system at Musgrove with no delays and no waits.”

Award recognises doctors for sexual health services to young people

DOCTORS in Williton and Watchet have been presented with an award for the advice and support they give young people seeking contraceptive and sexual health advice.
Known as the RESPECT Award, the accolade recognises the positive steps taken by GP surgeries in the two towns to address the specific needs of young people.
Surgeries which receive the award are able to display the RESPECT logo as an identifiable sign to young people that the practice appreciates their particular needs and concerns, respects their confidentiality, and will offer them objective advice.
Health professionals know that too many young people are still reluctant to access contraceptive or sexual health advice due to anxiety or embarrassment.
They mistakenly fear that they may be denied a service unless they are accompanied by their parent or carer, or that a service may not respect their confidentiality.
RESPECT Award surgeries have been able to demonstrate that young people will be welcomed, treated with respect, and have their specific needs met.
RESPECT Project Worker Sara Dove said: “It is wonderful that the surgeries have given such priority to the young people, who should feel confident that they will be welcomed and offered an excellent and confidential service.”
Both GP surgeries are also part of the Somerset Condom Card scheme which enables young people to not only obtain confidential advice and information, but also free condoms.
The scheme was established to address the difficulty many young people living in rural communities have accessing the dedicated contraceptive and sexual health clinics developed in larger towns such as Minehead.
Mark Withers C-Card co-ordinator, said: “By gaining the RESPECT award and operating the Somerset Condom Card these surgeries are ensuring that young people in rural areas have the opportunity to access high quality sexual health services as well as offering support around sex, relationships, and sexuality, enabling young people to make positive choices.”
While the GP surgeries do not have a dedicated young people’s clinic, they do ensure their services to young people are friendly and confidential.
Young people, who register with the Condom Card scheme, can collect free condoms from the reception without an appointment.
They will also be invited to make an appointment to discuss any health related issue, although, in the case of an emergency, every effort will be made for them to be seen without an appointment if they call in during surgery hours.
The RESPECT scheme is key to the work of the Somerset Teenage Pregnancy Partnership Board (STPS) and is supported by Somerset Primary Care Trust, Somerset County Council, and Connexions.
STPS aims to reduce the rate of under-18 conceptions by 50 per cent by 2010.