How Do We Find the Missing Millions? A Consultant Perspective

Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death worldwide, causing 3.2 million deaths in 2019.¹ In the UK, there are estimated to be 1.4 million people with a diagnosis of COPD.²

Despite its prevalence, many individuals have a delayed diagnosis or are misdiagnosed. The NHS Long Term Plan has outlined its commitment to do more to detect and diagnose respiratory problems earlier.³ As currently around a third of people with a first hospital admission for a COPD exacerbation have not been previously diagnosed.⁴

Dr Shashank Sharma presents on the epidemiology and the socioeconomic impact of COPD. He outlines what integrated care is and the necessity of integrated care in supporting patients, due to multi-morbidities and complexity associated with COPD.

Dr Sharma breaks down the areas in which integration care can help earlier diagnosis such as pooling of resources, access to guidance, shared learning and medical data and cost savings. He also presents an example of a good integrated service and associated practical solutions. Finally, Dr Sharma discusses the barriers, enablers and opportunities for integrated COPD care.

Please also consider watching the on-demand video ‘How Do We Find the Missing Millions? A Pharmacist Perspective’ by Nipa Patel who presents on the burden of COPD, the impact of earlier diagnosis and practicalities of finding undiagnosed patients.

References

1. GOLD (2024) Global Strategy for Prevention, Diagnosis and Management of COPD: 2024 Report. Global initiative for chronic Obstructive Lung Disease.

2. Asthma and Lung UK. COPD in the UK: Delayed diagnosis and unequal care. Executive Summary. https://www.asthmaandlung.org.uk/sites/default/files/2023-03/delayed-diagnosis-unequal-care-executive-summary.pdf

3. National Health Service. Th NHS Long Term Plan. https://www.england.nhs.uk/wp-content/uploads/2022/07/nhs-long-term-plan-version-1.2.pdf

4. Bastin, AJ., Starling, L., Ahmed, R., Dinham, A., Hill, N., Stern, M. & Restrick, LJ. (2010) High prevalence of undiagnosed and severe chronic obstructive pulmonary disease at first hospital admission with acute

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• Dr Shashank Sharma

  Respiratory Consultant and Clinical Lead

  Read biography
  Dr Shashank Sharma

  Respiratory Consultant and Clinical Lead Ashford and St. Peter’s Hospitals NHS Foundation Trust

  Role and Location
  Dr Shashank Sharma is a Consultant in Respiratory Medicine, specialising in asthma, chronic obstructive pulmonary disorder (COPD), pulmonary fibrosis, lung cancer and recurrent chest infections. Dr Sharma is the Clinical Lead for Respiratory Medicine in NHS Surrey Heartlands. He works closely with all the acute trusts as well as primary care in Surrey to develop respiratory services in line with national NHS priorities. One of his ongoing projects is to implement Targeted Lung Health Checks throughout Surrey Heartlands for early diagnosis of lung cancer.

  He is based at the St Peter’s Hospital in Chertsey, where he has led the development of Ambulatory Pleural Services, Sleep and CPAP clinic services. He is currently leading on Interstitial Lung Disease and TB. 

  Education
  Dr Sharma graduated from Tamil Nadu Dr MGR Medical University (Chennai, India) in 2001 and completed a Diploma in Chest Diseases from Delhi University (India) in 2004. He completed core medical training in Wales and then moved to London for specialist training in Respiratory Medicine. Dr Sharma completed his specialist Respiratory training in London and the Kent, Surrey and Sussex deanery, obtaining MRCP (Respiratory) in 2014. During his training he also took a year off to complete a postgraduate certificate in Medical Education from St George’s, University of London.

  Dr Shashank joined Ashford and St Peter’s Hospital (ASPH) in 2014 as a respiratory consultant, where he successfully introduced multiple new services including an Ambulatory Pleural Service and Medical Thoracoscopy, both of which are highly regarded. He has also set up a collaborative multi-disciplinary team (MDT) meeting with his respiratory colleagues at Royal Brompton Hospital, to improve the care of patients with pulmonary fibrosis at ASPH.

  Research
  Dr Sharma received Clinical Excellence awards in 2017 for the development of an Ambulatory Pleural Unit and in 2020 for leading the service development for the Covid-19 pandemic at Ashford and St Peter’s Hospital. 

  Memberships
  – MDU
  – Royal College of Physicians