NHS England's National Targeted Lung Health Check: preliminary findings

ABSTRACT

Introduction: The NHS England Targeted Lung Health Check (TLHC) programme is now live in 23 sites. Expansion to 20 further projects planned in early 2022 will enable every Cancer Alliance the opportunity to participate and scope requirements for a potential national programme. Combined, these cover a population of ~1.35m of an estimated 6.25m ever-smokers aged 55 to 75 nationally (ONS 2019). We present our preliminary findings. Methods: Data returns are collected from sites by the NHS Strategy Unit and collated by Ipsos MORI for independent evaluation. Data management summaries are available to the national team on a quarterly basis to review where improvements might be necessary. A ‘Shiny app’ dashboard summarises site level data returns on a monthly basis. Diagnosis data typically lag behind invitation, LHC and low dose CT (LDCT) completion data due to time taken to confirm diagnosis. Onboarded site data includes retrospective historical activity since inception. Results: 172,684 participants have been invited for TLHC (at 30th September 2021), with 57,409 TLHCs completed approximately equally split across 23 original and ‘onboarded’ sites (phase 2). 33,593 LDCT scans have been undertaken (22,986 baseline). 402 lung cancers are presently reported (1.75% of participants referred for LDCT), but can under-estimate most recent/earliest onboarded cancer diagnoses and require continuous quality assurance. Early data suggests ~80% of cancers found are stage 1 or 2. 95% of responders to the TLHC attendee survey rated their experience as ‘very good’ or ‘good’. The COVID-19 protocol addendum including virtual LHCs and pause on spirometry allowed the programme to continue to grow throughout the pandemic. Conclusions: TLHC teams have made impressive progress in engaging participants with their programmes despite a respiratory pandemic. Preliminary results are as expected and encouraging. Careful adherence to quality assurance and mitigation of potential barriers, particularly workforce is crucial to optimise further expansion