Public Health campaigns update (breathlessness and lung cancer) - James Brandon, Head of Marketing, Public Health England Presentation from the Breathlessness Symposium held in London on 1 July 2014

1. Breathlessness pilot campaign
James Brandon, Public Health England

2. Breathlessness background
Too many people die prematurely and suffer from poor health for entirely
preventable reasons. The Government, NHS England and Public Health
England are focussing on tackling premature mortality and improving the
quality of life for people living with long term conditions. This is not a new
problem and steps have already been taken to address premature mortality
and disease – including
• Our successful single issue campaigns - focussed on the biggest issue
diseases. They identify key visible symptoms of the disease, which can be
better managed with earlier presentation for diagnosis and treatment
(Cancer, Dementia and Stroke).
• NHS Health Checks – designed to check for other major disease and risk in
40-74 year olds every five years. They test for invisible symptoms such as
blood pressure, cholesterol and risk of type 2 diabetes.
• New blood pressure campaign pilot – to encourage people to go and get
their blood pressure checked out of the GP setting.

3. Breathlessness background continued
We are keen to trial other symptom awareness campaigns, particularly in relation to tackling
premature mortality as a result of cardiovascular disease. Following consultation with a range
of clinical experts, the decision has been taken to pilot a campaign to raise awareness of
breathlessness as a symptom of Chronic Obstructive Pulmonary Disease (COPD), heart failure
and lung cancer. The trial will start in Oldham and Rochdale on 24th February and, if
successful, will then be extended to other areas.
There are around 835,000 people currently diagnosed with COPD in the UK and an estimated
2,200,000 people with COPD who remain undiagnosed1. Late diagnosis has a substantial
impact on symptom control, quality of life, clinical outcome and cost as undiagnosed people
may receive inappropriate or inadequate treatment. Earlier diagnosis ensures that people with
COPD are given the right care and treatment that has the potential to slow down or modify the
progressive nature of this condition2.
Nearly 900,000 people in the UK have heart failure and almost as many have damaged hearts
but are yet to present with symptoms or signs of the condition. Heart failure carries a poor
prognosis and therefore survival is best determined by early diagnosis and treatment3.
Therefore our objective is
To encourage those with breathlessness to present earlier to their GP
.
1) https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216139/dh_128428.pdf
2) An Outcomes Strategy for Chronic Obstructive Pulmonary Disease (COPD) and Asthma in England. July 2011. Found at:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216139/dh_128428.pdf
3) http://www.nice.org.uk/nicemedia/live/13099/50517/50517.pdf

4. Target audience
50 years old + C2DE.
They have come to accept being out of breath as normal, unconsciously developing
coping mechanisms to deal with it everyday. It gets worse so gradually that they actually
don’t even notice it, until one day it may get so bad that they will have to go to the
hospital. Sadly at this point things may have deteriorated past the point of being able to
receive treatment.
Coping mechanisms include minimising everyday activities, avoiding leaving the home,
giving up hobbies such as gardening, becoming unable to walk or enjoy walking.
People who suffer from being short of, or out of breath normally wouldn’t say they do until
they are asked about it. Describing it is difficult, and very different to the medical
terminology a GP would use. Their description would normally relate to its effect on their
social and physical functioning.
Insight
Because it comes on so gradually, people who suffer from being short of breath seldom
even realise that they do. This means they don’t go to their GP about it – and even if they
do visit their GP they probably wouldn’t raise it as a specific symptom.

5. Campaign plan
A pilot campaign in Oldham and Rochdale from 24 February to 23 March 2014
Channel w/c 24
Feb
w/c 3
March
w/c 10
March
w/c 17
March
Awareness&
relevance
Bus stop
posters,
GP
surgeries,
pharmacy
bags
Local
press
Local
radio
Inform
Search
Website

6. Campaign creative
The campaign followed the same creative look as the Be Clear on Cancer print
advertising and features a doctor with a simple message and then further
information.
The simple message that most resonated with our audience was “If you have
started to get out of breath doing things you used to do, tell your doctor. Getting
out of breath could be a sign of heart or lung disease. Finding it early makes it
more treatable, so tell your doctor”. We also supported this execution with
others that tackle smoking, age and being overweight as reasons for
breathlessness.
A campaign leaflet and poster were widely available.

7. Research & evaluation
• Qualitative research on preliminary creative concepts
• Public aged over 50, C2DE, Influencers
• GPs
• Quantitative evaluation research to measure campaign awareness
• Pre and post tracking surveys among the public in both pilot and
control areas
• Campaign Impact:
• GP attendance data for breathlessness symptom
• Data for relevant diagnostic tests and outpatient referrals to
relevant clinics