Written questions by Hamilton.

What steps his Department is taking to increase the capacity of secondary care to support primary care with essential respiratory diagnostics.

Following a significant drop in the volume of spirometry during the pandemic, NHS England has already worked with a range of partners, including Asthma and Lung UK, the British Thoracic Society, the Association of Respiratory Technology and Physiology, and clinical leads to develop a package for systems containing the information and support required to help increase the number of people receiving early and accurate diagnosis for respiratory disease.NHS England’s priorities and operational planning guidance for 2024/25 also highlights the importance of timely access to diagnostics, including spirometry, asking systems to utilise new diagnostic capacity in the community to commission these tests. Additional funding has been made available to systems in 2021/22, 2022/23, and 2023/24 for the training and accreditation of staff in the provision and interpretation of quality assured spirometry, a key component of an early and accurate diagnosis. In 2023/24 and 2024/25, the national team is financially supporting systems to take innovative approaches to expanding access to their diagnostic services, focusing particularly on addressing health inequalities.

What steps he is taking to ensure spirometry testing is (a) funded and (b) available in areas covered by the Birmingham and Solihull Integrated Care Board.

Spirometry testing is provided at the Washwood Heath Community Diagnostic Centre (CDC), along with other respiratory diagnostic tests such as fractional exhaled nitric oxide and lung function tests. The same tests will also be available at the North Solihull and South Birmingham CDCs when they go live next year. Mobilisation meetings are underway with the provider to establish that these services are ready to go live.All tests and funding seen in the CDC have a tariff attached to them, which incentivises systems to develop diagnostic pathways, including for respiratory health, that take place in the community. These tests are local, accessible, and offer timely appointments. There are now three CDCs approved in Birmingham and Solihull, which shows a system shift to a community-based delivery model for all diagnostics, and spirometry testing is key to diagnosis a number of conditions affecting a large number of the local population.

What steps his Department is taking to tackle rates of respiratory-related hospital admissions in Birmingham.

System partners are working collaboratively to improve pathways between health care professionals, and to remove barriers in referrals to community-based services and hospital acute setting clinics. This will support admission avoidance, and ensure that patients are receiving the right care in the right place, more quickly.An example of this is the work between the West Midlands Ambulance Service University NHS Foundation Trust (WMAS) and urgent community response, who are supporting the WMAS with direct referrals into their service, and providing a call before you convey the telephone line for ambulance clinicians on the scene with patients. Increasing the workforce skill mix in the urgent community response to support with decision making will avoid admissions. Support to care homes to ensure they can safely monitor and escalate, where patients become unwell, to appropriate health care professionals has been supported by urgent community response teams and virtual ward teams. We are also improving respiratory virtual ward utilisation in collaboration with both the University Hospitals Birmingham NHS Foundation Trust and the Birmingham Community Healthcare NHS Foundation Trust.

What steps he plans to take to ensure that Community Diagnostic Centres are accessible to everyone in (a) Birmingham Erdington constiituency and (b) England.

The Community Diagnostic Centre (CDC) programme now delivers activity on 168 sites across the country, and data published in August 2024 showed CDCs have delivered over 10.4 million diagnostic tests since July 2021.The National Health Service has endeavoured to ensure that each integrated care system (ICS) has at least two CDCs, and there is now a standard or large model CDC approved in every NHS integrated care system area. Locations of CDCs were determined based on a set of specific criteria, including need for diagnostic provision, accessibility for patients by private and public transport and factors which would support health inequalities.Whilst there is no CDC located in the Birmingham Erdington constituency, Birmingham and Solihull ICB hosts three CDCs in the local area, including Washwood Heath CDC in Saltley, North Solihull CDC in Chelmsley Wood and South Birmingham CDC in Maypole. CDCs provide additional, digitally connected, diagnostic capacity in England, which supports existing diagnostic capacity, including at acute sites such as at Birmingham Heartlands Hospital.NHS England is also supporting systems to make a wider range of direct access tests available to general practices (GP) nationally and in Birmingham, through the GP Direct Access Scheme. This includes via direct referrals to CDCs, than need for a pre appointment and to increase speed of access. Phases 1 and 2 of the GP Direct Access Scheme are focussed on expanding use of direct access tests for cancer and respiratory conditions, including chronic obstructive pulmonary disease.The Government has committed £1.5 billion of capital funding for new surgical hubs and diagnostic scanners. This will build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests, as well as new beds which will create more treatment space in emergency departments, reduce waiting times, and help shift more care into the community. More details will follow in due course.

What steps his Department is taking to (a) tackle workforce shortages in respiratory care and (b) ensure (i) GPs and (ii) their teams have access to (A) training and (B) accreditation for (1) spirometry and (2) other diagnostic tests.

We have launched a 10-Year Health Plan to reform the National Health Service and make it fit for the future. Ensuring we have the right people, in the right places, with the right skills, including for respiratory care, will be central to this vision.The Royal College of General Practitioners (RCGP) sets the postgraduate curriculum for general practitioners (GPs) and ensures it remains up to date. All GPs must cover the curriculum before they are able to pass the examination to become a member of the RCGP and to work independently as a GP.NHS England provides a wide range of resources to the NHS via the eLearning for Healthcare platform, including a respiratory diseases toolkit on the prevention and management of respiratory conditions, and diagnostic tests such as spirometry.