Comprehensive review of interstitial lung disease (ILD) specialised service provision and workforce in England

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Introduction: There are 23 specialised services in England that support accurate diagnosis, monitoring, and management of interstitial lung disease (ILD) and related comorbidities. Recent advances have led to earlier identification and diagnosis with increased access to treatments. We explored ILD specialised service provision and workforce in England. Method An electronic survey was sent to 23 ILD services. Results: 22/23 ILD specialised services responded. In 2022, ILD services received 10,358 new referrals. Of these, 2883 (27.8%) patients were initiated on antifibrotic therapy. Workforce varied in time dedicated to ILD (table 1). The waiting times from receipt of referral to first appointment ranged from 5 to 33 weeks. Supportive care services were accessible to most patients with ILD. Table 1. ILD service provision and workforce in ILD specialised services in England erj;64/suppl_68/PA2302/TB1 T1 TB1 Mean Range New referrals 471 120-2100 New antifibrotic prescriptions 137 33-604 Respiratory consultant (PA) 4 (13 PA) 1-7 (1-55 PA) ILD clinical nurse specialist (WTE) 3 (2.3 WTE) 1-4 (1-4 WTE) ILD pharmacist (WTE) 1 (0.8 WTE) 0-4 (0-2.3 WTE) PA = programmed activity 1 PA = 4 hours WTE = whole time equivalence Conclusion: There is significant variability in ILD service provision and workforce across the ILD specialised services leading to unwarranted variation in waiting times for diagnosis and access to treatment. Approaches to standardise care and ensure adequate workforce, according to caseload, are needed.

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