NHS Lung Health Checks

The NHS Long Term Plan, published in January 2019, sets out a wide range of ambitions for the NHS to achieve over the next 10 years. A number of these ambitions centre on improving cancer survival through earlier diagnosis, with the Plan committing to increase the proportion of cancers diagnosed early from half to three quarters by 2028. This increase would mean 55,000 more people each year surviving for at least 5 years after diagnosis.

The NHS recognises that lung cancer is an area where early diagnosis is desperately needed to help improve survival and NHS Lung Health Checks are therefore being extended into 10 sites with some of the highest rates of lung cancer deaths in England. One of these sites is Newcastle Gateshead. As well as helping to diagnose lung cancer at an early stage, lung health checks will also help identify other lung conditions.

Lung cancer is often diagnosed at a late stage because symptoms aren’t always apparent until the disease is advanced, or because people are too worried about being diagnosed with lung cancer to seek help. NHS Lung Health Checks help detect early stage lung cancers, often before people have any symptoms and at a point when treatment is simpler and more successful. This is done by identifying those people most at risk of developing lung cancer and offering them a CT scan. The CT scan can help identify early changes.

A recent study (NELSON Lung Cancer Trial) showed that scanning people at higher risk of developing lung cancer reduced mortality from the disease by 26% in men and between 39 and 61% in women.

Across the 10 sites, it is expected that around 3,400 lung cancers will be detected. As many of these cancers will be early stage, this will mean that hundreds of lives will be saved.

Between April 2021 and October 2023, over 48,000 people in Newcastle and Gateshead will be invited to attend an NHS Lung Health Check. If you receive an invitation, please attend your check: it might just save your life.

There are over 60 GP practices across Newcastle and Gateshead and patients will be invited to an NHS Lung Health Check on a practice-by-practice basis. Over 48,000 invitations will be issued between April 2021 and October 2023.

It’s important to be aware of the signs and symptoms of lung cancer, as it could develop before your Lung Health Check or after you’ve had your check. We would ask that you seek further advice from your GP if you have any concerns about the following symptoms:

• a persistent cough or change in your normal cough (if you have any of the main symptoms of coronavirus (a new continuous cough, a high temperature, or a loss or change to your sense of smell or taste) visit the NHS website for advice or call 111, stay home and order a test as soon as possible)
• coughing up blood
• being short of breath
• unexplained tiredness or weight loss
• an ache or pain when breathing or coughing appetite loss

Patients will receive an appointment letter for an NHS Lung Health Check if they:

• Are registered with a GP practice in either Newcastle or Gateshead
• Smoke or used to smoke
• Are aged between 55 and 74 years at the point their practice population is invited to an NHS Lung Health Check.

It’s important that your smoking status is recorded correctly in your GP record so that you receive an invitation. If you’re not sure whether it is, please check at your next appointment.

An appointment for a lung health check will be made for you and you will receive this via a letter. If you need to change your appointment, you can do so by calling the number in the letter.

You have received an invitation because your GP record shows that you smoke or used to smoke. Don’t ignore your invitation: NHS Lung Health Checks save lives!

If you smoke or used to smoke

If you currently smoke or have smoked in the past, you will receive an appointment letter. If you need to change your appointment, please contact the NHS Lung Health Check Team using the information in your letter. Please do this within two weeks of receiving your letter so that you don’t miss your chance to have an NHS Lung Health Check.

Some people may feel worried about having an NHS Lung Health Check. We are happy to answer any questions you may have about the checks. We have also produced a series of Frequently Asked Questions (FAQs) which might answer your questions with the need to contact us.

If you have never smoked and don’t believe you should have received an invitation:

1. Contact the NHS Lung Health Check Service to speak to them about the invitation. They will be able to advise you.
2. If, after speaking to the NHS Lung Health Check Service, you still don’t believe you should have received an invite to an NHS Lung Health Check, contact your GP to ask that they correct your patient record.

There are strict eligibility criteria for an NHS Lung Health Check, as set by NHS England. To be eligible, you must be:

• Registered with a GP in either Newcastle or Gateshead
• Aged 55-74 at the point invitations for patients from your practice are issued
• A current or former smoker

If you don’t meet the eligibility criteria, you will not be invited for an NHS Lung Health Check.

If you feel you meet the eligibility criteria and you haven’t received an invitation, there could be a number of reasons for this:

1. Invitations for patients from your practice have not yet been sent out.
2. Your smoking status has not been recorded on your GP record; if you think this may be the case, please contact your GP practice. Your practice should be able to update your record and this may mean that you are invited for a lung health check.
3. You are not registered with a GP in either Newcastle or Gateshead, although you may live in one of those areas.

If you think we may already have invited patients from your practice to an NHS Lung Health Check and your smoking status was not accurately recorded on your GP practice system, please contact 0191 282 4888 for further advice.

To ensure patient safety with regards to COVID-19, Lung Health Checks will be completed over the telephone. You will only need to attend an appointment in person if you are asked to have a CT scan.

A specially trained NHS Lung Health Check Nurse will phone you within 15 minutes of your agreed appointment time to carry out your check. The appointment will last around 30-45 minutes. The Nurse will ask you a number of questions about your health, lifestyle and history, including any personal history of cancer or family history of lung cancer. The answers will be used to assess your risk of developing lung cancer in the future. If you are assessed as being at increased risk of lung cancer, you will be offered a low dose CT scan. If you are offered a scan, the Nurse will talk you through the benefits and risks, and you’ll be able to ask any questions you may have. An appointment for your CT scan will be booked for you.

After your scan, you will receive your results within around 4 weeks. Your GP will also be contacted with the results of your scan.

Watch our video on NHS Lung Health Checks for more information.

More information about the NHS Lung Health Check is included in the leaflet you receive with your invitation. You can download a copy of this leaflet here.

If you had a low dose CT scan as part of your NHS Lung Health Check, you should expect to receive the results of this within four weeks of your scan. If you have not received the results, please contact 0191 282 4888.

Your CT scan will take place in a mobile unit in a community venue. You will not be asked to come into a hospital for your scan. Because of the current situation, we are taking extra precautions to keep people safe.

All of our staff will follow strict infection prevention and control measures to minimise any risks to patients. To help with this, please arrive at your appointment wearing a face covering and wait outside the mobile unit until your appointment time.

Equipment is being cleaned after each appointment and our waiting areas have space to allow for social distancing.

The mobile unit moves regularly, so you will be told where the unit will be at for your appointment when you book your CT scan. You’ll also be given a map showing how to get to the unit when you receive your appointment confirmation letter.

The scan only takes a few minutes, but your appointment will take around 20 minutes in total. When you arrive at your appointment, we will take your height and weight to make sure we have this information correct in your record.

During the scan, you will be asked to lie flat on your back on a bed that moves slowly into the CT scanner. You don’t need to take any of your clothes off, although if you are wearing any jewellery or metal, you will be asked to remove these. The scan is completely painless. You’ll need to lie still and follow a few simple breathing instructions for 10 seconds to make sure we can get a clear picture of your lungs.

There will be a specially trained member of staff in the room throughout your scan. This member of staff will operate the scanner from behind a screen.

The scanner uses radiation to take an image of your lungs. You will be exposed to a small amount of radiation as a result; this is about the same as a year’s worth of radiation from the natural environment.

After the scan, you will be able to continue your day as normal. You will receive your results around 4 weeks after your scan.

The main purpose of the CT scan is to identify lung cancer at a stage when it can be cured. Small and early lung cancers can often be removed completely by operation or treated with radiotherapy. Most lung cancers grow slowly enough that they can be found at an early stage by a low dose CT scan; people found to have lung cancer through regular scanning are nearly 3 times more likely to be diagnosed with an early stage lung cancer than those not scanned. This is why those at an increased risk of developing lung cancer are being offered a CT scan.

Your CT scan could be normal. This means that nothing that is going to have a significant impact on your health has been found at this time. The majority of people (around 3 in every 4) will have a normal result. If your CT scan is normal, you will be invited back for a second scan in 24 months’ time. This is so we can monitor your lungs and pick up any changes at an early stage, but things could change in between scans and you should be aware of any changes in your health and seek advice from your GP if you notice anything. Information about the signs and symptoms of lung cancer can be found on Cancer Research UK’s website.

The scan could also find other lung conditions that you might have. There is also a very small chance that we could find something that’s not in your lungs but is in another part of your body close to your lungs. This is very unlikely as the scan looks mainly at your lungs, but it is possible, and if we do find something which needs further tests, we will be in touch with you and your GP.

If something is found on your CT scan, the findings will guide our next steps. You could be invited for a follow-up scan in around 3 months so that we can keep a closer eye on your lungs, or you may be referred to the hospital for further investigations. For every 100 people having a scan, around 17, will be offered a 3 month follow-up scan, and around 8 will go to hospital for further tests. If you’re referred to hospital, it doesn’t mean you have cancer, it just means that we need to do further tests to find out exactly what we’ve found so that we can offer the most appropriate treatment to you. Of the 8 out of every 100 people referred to hospital, only 4 will be found to have a lung cancer and most of these will be at an early stage and be cured.

NHS Lung Health Checks can very occasionally pick up on abnormalities which look like a lung cancer but aren’t. This could mean that you need further tests, which have risks, and it can also cause anxiety.

Occasionally a lung cancer will be missed on CT. It is very uncommon but it is important to be aware of the signs and symptoms and speak to your GP if you’re worried.

CTs can also rarely find lung cancers which would never have caused a person harm, and as a result, some people will require tests and receive treatment which would otherwise have not been needed.

We follow strict rules to ensure that any risks from the CT scan and findings are reduced as much as possible, and if anything is found on your scan, you will have access to experienced clinicians who can talk to you about the tests and your worries.

You will receive the results of your CT scan within 4 weeks of your scan. Your GP will also receive a copy of your results.

If you have any questions when you receive your results, please contact us using the number in your results letter.

The most important thing you can do to keep your lungs as healthy as possible is to stop smoking if you currently smoke. There are services in your local area which can support you to stop smoking.

If you live in Newcastle, contact Newcastle Stop Smoking Service + on 0191 269 1103 or newcastle.stopsmoking@cgl.org.uk

If you live in Gateshead, contact SmokeFree Gateshead on 0191 433 3058 or smokefree@gateshead.gov.uk

• NHS lung cancer information
• NHS Smokefree

• Lung Health Checks
• Lung Cancer
• Smoking

• Information about lung cancer

Participants assessed at their Lung Health Check as being at a greater risk of developing lung cancer will be offered a low dose CT scan. It is estimated that around 3,400 cancers will be found across the 10 Phase 1 TLHC sites. Many of these cancers will be found at an earlier stage than they would otherwise have been found, meaning that the NHS will be able to offer more treatments, such as curative surgery, to patients, which will save lives.

NHS England is conducting a national evaluation to understand the impacts and economics of the programme. The evaluation is expected to demonstrate impacts on patient health outcomes, experience and wider health inequalities. Findings from the evaluation will ensure an evidence-based approach to NHS England’s longer-term strategy for wider roll out of a targeted screening programme of this kind.

This approach involves an analysis of data collected by the programme, and information recorded in interviews with patients and staff about their experiences.

Ipsos Mori, together with the Strategy Unit at the Midlands and Lancashire Commissioning Support Unit (CSU), which is part of NHS England, have been appointed jointly as our national evaluation partner.

NHS England’s Privacy Notice for the TLHC Programme can be found here.

Across the 10 Phase 1 sites, CCGs/Cancer Alliances are co-ordinating the TLHC services locally, acting for their constituent GP practices.
Patients will be invited to their Lung Health Check by the service provider commissioned by CCGs/Cancer Alliances to deliver the Lung Health Checks, before being referred into secondary care for further investigations and treatment (where necessary). This service provider could constituent GP Practices or a local Hospital Trust. In Newcastle Gateshead, the service provider is The Newcastle-upon-Tyne NHS Foundation Trust.

Personal data about patients is collected across the pathway to enable the delivery of the TLHC service locally. The national evaluation partner receives a data set from the CCGs for the purpose of evaluation. Participants will not be identifiable from this dataset. The dataset will include information on sex, age, marital status, main language, occupation, information about diagnosis, treatment and outcomes.
The evaluation partner will also collect information about the experiences of participants and staff, facilitated by the CCGs/Cancer Alliances. Information will be recorded in a way to ensure that individuals cannot be identified.