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Pioneering lung service for people in South Lakeland

Dr Tim Gatheral and ILD Specialist Nurse Claire Lee UHMBT

A pioneering service for people with chronic forms of lung disease is being offered by University Hospitals of Morecambe Bay NHS Foundation Trust and NHS partners in Preston and Blackburn.

The Lancashire and South Cumbria Interstitial Lung Disease (ILD) Service is helping to give local patients with scarring and fibrosis of the lungs an increased life expectancy and preservation of their quality of life.

Dr Tim Gatheral, a consultant respiratory physician, senior clinical lecturer with Lancaster Medical School and lead member of the Morecambe Bay Respiratory Network, works in partnership on the service with colleagues from Royal Blackburn Teaching Hospital and Lancashire Teaching Hospitals NHS Foundation Trust.

Tim said the new Lancashire and South Cumbria ILD service has been well received and patients who previously had to travel to Manchester for treatment are now being seen much closer to home.

ILD refers to a group of around 100 chronic lung disorders characterised by inflammation and scarring that make it hard for the lungs to get enough oxygen.

The scarring is called pulmonary fibrosis and the symptoms and course of these diseases varies from person to person. It affects around one in 4,000 people and there is no known cause.

Tim specialises in Idiopathic Pulmonary Fibrosis (IPF), a form of ILD characterised by damage to the lung accompanied by an uncontrolled healing response that causes progressive scarring or thickening (fibrosis) of tissues between the lungs’ air sacs.

He sees ILD patients at specialist clinics at Furness General Hospital in Barrow, Westmorland General Hospital in Kendal and the Royal Lancaster Infirmary.

Around 30 of these patients are currently receiving treatment for IPF.

Tim said: “I am glad that our patients no longer have to endure long journeys to receive treatment and that their conditions can be managed through our clinics at our sites.

“This has been the culmination of a lot of work to gain equitable access for patients across our patch.

“Traditionally, ILD has been thought of as quite rare, however it kills about one per cent of the population each year.

“It is a very serious disease and the prognosis after diagnosis is around three to five years before death. It’s as serious as many forms of cancer.

“IPF didn’t previously have any treatments that were particularly effective but over the last five to ten years there has been an emergence of specific therapies that slow the progression of the disease.

“At our accredited ILD clinics in Morecambe Bay, Preston and Blackburn, we have greatly improved investigation and management of patients’ lung conditions.”

Until quite recently patients from Morecambe Bay, including particularly remote areas of South Cumbria, had to travel to a specialist centre in Manchester.

Tim said the new service addresses the postcode injustices which can mean that patients who live further away from specialist respiratory centres, don’t always receive the levels of treatment they need.

Tim, who joined the UHMBT Respiratory Service in 2014, has appointed Claire Lee, an ILD specialist nurse.

Claire and Tim run the ILD clinics at UHMBT with support from the trust’s specialist respiratory nurses, advanced nurse practitioners, doctors and the wider respiratory team.

Tim said: “At our clinics we can prescribe specialist drugs such as Pirfenidone and Nintedanib which can halve the rate of progression of the disease.

“These drugs can also increase life expectancy and take longer for patients to have a flare up.

“It’s not possible to cure the disease but we can try to control the progression and maintain people’s quality of life.”

Ian Johnson, a semi-retired Trading Standards and animal welfare specialist who does contract work with local authorities, has been using the ILD service since he was diagnosed with pulmonary fibrosis earlier in 2020.

Ian, said: “I have had excellent care and treatment from Tim and the rest of the team. Everyone has been very helpful and supportive. I have nothing but good things to say about the service. It’s brilliant!”

Ian’s pulmonary fibrosis was detected through a CT scan and was identified by Dr Urmi Gupta, a respiratory consultant, from UHMBT.

Ian has been on Pirfenidone for the last few months and his last lung function tests showed an improvement.

Ian said: “When I got the results it was cause for celebration! If it hadn’t been for the COVID pandemic, our whole family would have got together.

“The medication keeps things in abeyance and stops it from galloping along and getting worse.”

Ian also does physiotherapy exercises to keep fit and he is a keen walker.

He lives in South Cumbria and is pleased that he doesn’t have to travel to Manchester to receive treatment.

He is also happy that he only has to make a short trip to Barrow or Kendal for check-ups.

He said: “At first I was getting my medication prescribed by specialists in Wythenshawe but now it’s so much easier. It’s close to home and very handy.”

Ian, who is 70 years old, married and has three children and three grandchildren, added: “I’m feeling very well just now. My family are very happy.”

Tim added: “The ILD service is united with the Morecambe Bay Respiratory Network and many more patients are now being picked up earlier with ILD which is hugely positive for all concerned.”

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