Targeted Lung Health Checks
Since 2018 RM Partners has been providing targeted lung health checks as a pro-active approach to diagnosing lung cancer at an early stage in patients before they develop symptoms.
This programme invites people identified as being at increased risk of lung cancer due to their age and smoking history, for a lung health check. Depending on the results, people may then be offered a CT scan in a convenient place, close to home.
The programme builds on several landmark studies, including the 2018 NELSON study, which has reported a 26% reduction in lung cancer deaths when high-risk patients had a lung health check and CT scan.
Current or ex-smokers aged between 55 and 74 are invited via their GP to attend a lung health check. The health check, led by a respiratory nurse, consists of a brief telephone consultation covering any respiratory symptoms and past medical and smoking history. A risk assessment tool, in the form of a questionnaire, is used to determine whether the person is at increased risk of lung cancer.
If they are, the person is then offered an appointment for a low dose CT scan. The scans are reviewed and reported back to the patients and their GP within 4 weeks. Where appropriate, patients can be referred to hospital or their GP if any follow up is required, as well as to a local stop smoking service.
Our pilot initially involved 17 GP practices with patients in Hammersmith and Fulham invited to Royal Brompton Hospital for their lung health check, and patients in Hillingdon, who were invited to a mobile CT unit in a local supermarket car park – the first of its kind in London.
We published the results of our pilot in the Lung Cancer Journal, whereby almost 10,000 people were invited for a lung health check. The pilot replicated national and international studies in finding early cancers as well as conditions such as COPD.
In April 2020, the project became part of the NHS England national Targeted Lung Health Check programme. We have since expanded to invite all GP practices in Hammersmith and Fulham and in Hillingdon to participate, as well as launching in Sutton in May 2021, thanks to a partnership of local primary care GP leads, Epsom and St Helier University Hospitals NHS Trust, and the Royal Brompton and Harefield hospitals. We are now offering all eligible patients in Hammersmith and Fulham, Hillingdon, and Sutton a lung health check and CT scan if required, and a second scan after 2 years.
In April 2022 NHS England announced a nationwide roll out of the programme and we are now expanding across all 14 boroughs in north west and south west London, with full coverage expected by 2028. This began in December 2022 when we launched into Hounslow, Merton, and Wandsworth. From October 2023 we will be opening the service in Croydon and Ealing, with the remaining boroughs coming onstream during 2024.
In September 2022 the UK National Screening Committee recommended that the four UK nations should move towards implementing a targeted national lung cancer screening programme, integrated with smoking cessation services, for people at high risk. The committee noted that, to help implement a UK-wide programme, more modelling work is needed to further refine its recommendations, address implementation challenges, and determine the optimum protocols and pathway for the implementation of screening across the UK.
For more information please contact Jane Derbyshire, senior project manager.