March 2015
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Content
1. Executive summary
2. Campaign overview
3. Key messages
4. Facts & stats
5. Article templates
6. Social media
7. Adverts
Page Number
Page 3
Page 4
Page 5
Page 9
Page 10
Page 11
Page 13
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1. Executive summary
Public Health England has launched a regional campaign in the East of England to help raise awareness of breathlessness as a symptom of heart or lung disease.
* The campaign is run in partnership with the Department of Health and NHS England.
This regional campaign follows a successful local pilot in Greater Manchester (Oldham and
Rochdale), which ran in February - March 2014, and led to an increased awareness of breathlessness as a potential indicator for something more serious.
This campaign, like the local pilot, will encourage those who get out of breath when doing everyday activities, such as walking upstairs or getting dressed, to visit their GP.
The campaign includes regional television, print, radio, digital, out of home advertising, roadshows and PR, and we are asking for your help in raising awareness amongst your audiences through your channels. This toolkit includes advice, information and templates to help with this.
To help put the campaign into context:

It is thought that there are over 2.2 million people living with COPD in the UK, but only around
835,000 have been diagnosed.
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
Therefore two-thirds of people with lung disease may not even know they have it, and many of these will be coping with breathlessness.

It is estimated that there are nearly 46,000 people with undiagnosed lung disease in the East of England.
2

There are already around 230,000 people with diagnosed heart disease in the East of
England, but it is estimated that there are over 76,000 people still undiagnosed.
2
The overarching objective of the campaign is to encourage earlier presentation of breathlessness to allow prompt treatment. This forms part of the government’s wider ambition to help reduce premature avoidable mortality rates and improve the lives of people with long-term conditions through earlier diagnosis.
The key message used in the campaign is: If you get out of breath doing things you used to be
able to do, tell your doctor
Checklist of activity
There are a number of activities and opportunities that can be utilised to help continue momentum:

Use the short or long copy templates below to help draft articles about the campaign for newsletters, websites or social media networks

Feature campaign key messages and facts and in any communications about the campaign

Utilise available social media networks, e.g. Facebook and Twitter, to provide regular updates and information on the campaign, to help maintain momentum
Please also encourage others in your area to promote the campaign, using these template materials and suggestions for social media, if they wish.
Good luck with your activities and thank you in advance for all your help.
*
Including COPD (Chronic Obstructive Pulmonary Disease) - a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease
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2. Campaign overview
The government has set out its ambition to help reduce premature avoidable mortality and improve the lives of people with long-term conditions through earlier diagnosis. This regional campaign follows a successful pilot campaign in Greater Manchester (Oldham and Rochdale) in February 2014, which encouraged those experiencing breathlessness doing everyday activities that they used to be able to do, to see their GP straight away to allow prompt treatment.
Breathlessness can be a symptom of conditions such as heart disease and lung disease, including:
Chronic Obstructive Pulmonary Disease (COPD), lung cancer, and heart failure, which, if diagnosed early, are more treatable. Breathlessness can also be associated with other conditions such as anaemia or anxiety and other mental health problems.
Many people who suffer from breathlessness often find coping mechanisms for their condition, for example taking breaks when walking to cope with the fact that they’re getting out of breath, which result in them not mentioning it to their GP. Therefore they do not get the opportunity to be examined, tested, diagnosed and given the appropriate treatment.
Looking at COPD alone, it is thought that over 2.2 million people are living with the disease in the UK, including nearly 123,000 in the East of England, but it is thought that there are still 46,000
undiagnosed in this area.
2
More than 750,000 people in the UK have heart disease, 3 and there are already around 230,000 in the East of England.
4
There are however still 76,000 estimated to be undiagnosed.
2 Of those people
admitted to hospital with heart disease in 2012/13, almost 80% had moderate to severe
breathlessness.
15 Heart disease carries a poor prognosis, especially if untreated, and therefore early
diagnosis and treatment is important.
The objective of the campaign is to bring breathlessness to the forefront of the public’s attention, and increase awareness that feeling short of breath could be an indicator of something more serious, such as heart or COPD. So, rather than finding ways to cope, those affected should go and see their doctor.
The campaign is targeted at men and women aged over 50 - the age group which is most likely to experience breathlessness. It is also aimed at their friends and family who can pass on information and e ncourage loved ones to make an appointment with their doctor if they’re concerned.
The campaign includes adverts on regional TV channels, radio and in print publications. Adverts will also be played in GP surgeries and print adverts will be printed onto pharmacy bags in the area.
Activity for disabled people
Disabled people make up a proportion of the target audience of the campaign and are known to have worse health outcomes than the general population.
Fact-finding found people with sensory impairments and learning disabilities are more likely to be excluded from the mainstream communications and often have problems spotting the signs and symptoms of illnesses. Steps have been made to ensure the campaign communications are as accessible as possible.
Engagement is also taking place with disability and older peoples organisations such as yourselves and to raise awareness breathlessness amongst these audiences, communicate bespoke messages and raise awareness of the availability of the alternative formats.
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The mainstream leaflet has been produced in alternative formats, including Braille, audio, large print,
BSL and easy read. These can be downloaded at nhs.uk/outofbreath or hard copies can be obtained from enquiries@phe.gov.uk.
For more information please contact barry@bdscommunications.co.uk or phone 07808 707288.
3. Key messages

If you get out of breath doing things that you used to be able to do, tell your doctor.
Secondary Messages

Do not just put feeling out of breath down to smoking, tell your doctor.

Getting older is not necessarily a reason to feel out of breath, so tell your doctor.

Being overweight is not necessarily a reason to feel out of breath, so tell your doctor.
Breathlessness messages 
Breathlessness could be a symptom of heart and lung disease (including chronic obstructive pulmonary disease
(COPD)).

Everyone will experience breathlessness now and again however, sometimes being short of breath could be a sign of something more serious.

Breathlessness may involve:
▪ difficult breathing
▪ uncomfortable breathing
▪ feeling like you are not getting enough air
▪ more rapid breathing

Early diagnosis and treatment for heart and COPD – for all of which breathlessness can be a symptom - has the potential to save lives and also to improve the quality of life of those living with long-term conditions.

You need to see your doctor straight away if you have
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Heart disease been experiencing breathlessness while doing everyday activities such as: o vacuuming o mowing the lawn o walking at normal pace (and struggling to keep up with friends) o moving from the sofa to make a cup of tea o dressing and undressing yourself o climbing short flights of stairs

Breathlessness could also indicate other health problems such as asthma, anaemia or anxiety.

If you know anyone who has any of these symptoms, insist they see their doctor. It is probably nothing serious, but they should get it checked out.

While most people know that chest pain can signify the presence of heart disease, it is less well known that breathlessness can also be a symptom.

Heart disease means your heart is having trouble pumping enough blood around your body, usually because the heart muscle has become too weak or stiff to work properly.

Heart disease is common in England, especially in smokers, and is one of the main causes of breathlessness.

It is important to get heart disease treated early.

A heart attack happens if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can't get oxygen. Most heart attacks occur as a result of coronary heart disease (CHD).

There are around 230,000 people with diagnosed heart
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disease in the East of England.
2

It is estimated that there are over 76,000 people with
undiagnosed heart disease in the East of England.
2
Lung disease (including
COPD) messages

Lung disease includes COPD - a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease.

COPD stands for chronic obstructive pulmonary disease and it is a serious lung disease that makes it harder to breathe.

Lung disease is one of the most common respiratory diseases in the UK. It usually affects people over the age of 35, although most people are not diagnosed until they are in their fifties.
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
Lung disease symptoms can vary, but may also include: 6 o persistent cough o regularly coughing up phlegm o wheezing o weight loss o extreme tiredness o waking up at night as a result of breathlessness o swollen ankles

There are nearly 123,000 people with diagnosed COPD
in the East of England 2

It is estimated that there are nearly 46,000 people with
undiagnosed COPD in the East of England 2

It is thought that there are over 2.2 million people living with COPD in the UK, of which only around 835,000 have
been diagnosed.
1
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Lung cancer messages
Anxiety

It is important that lung disease is diagnosed as early as possible to make it more treatable.

Breathlessness is a key symptom of lung cancer, the second most common cancer for both men and women in
England.

Finding lung cancer early makes it more treatable.

Lung cancer affects people of all ages but is most common in those who are over 50. Although it is more common in smokers, around one in eight people with lung cancer has never smoked.

Knowing the symptoms of lung cancer, particularly breathlessness and persistent cough, and going to see the doctor early, could save your life.

Anxiety can cause breathlessness on its own, but it can also occur alongside other causes.

Rapid or deep breathing (often called hyperventilation), is just one possible symptom of anxiety, which may result in feelings of breathlessness.
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4. Facts & stats

One in 10 suffer breathlessness, 7 and this increases to 30% for the elderly.
8

Breathlessness may involve: difficult breathing, uncomfortable breathing or feeling like you are not getting enough air.

Breathlessness is a key symptom of respiratory disease, England’s third biggest killer.
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
Lung disease includes COPD.

COPD stands for chronic obstructive pulmonary disease. It is the name used to describe a number of conditions, including bronchitis and emphysema. Difficulties breathing is due to a narrowing of the airways.

The main cause of lung disease is smoking. Other causes include fumes, dust, air pollution and genetic disorders, but these are rarer.

There are over 2.2 million people living with COPD in the UK, of which only around 835,000
have been diagnosed.
1
In England alone, around 23,000 people die from lung disease each year.
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
Lung disease is the second most common reason for emergency admission to hospital.
11

Lung disease is one of the most common respiratory diseases in the UK. It usually affects people over the age of 35, although most people are not diagnosed until they are in their fifties.

It is estimated there are nearly 46,000 people with undiagnosed lung disease in the East of
England.
2 Ошибка! Закладка не определена.

Persistent breathlessness can also be a symptom of lung cancer, the second most common cancer in men and women in England.
12 There were just under 36,000 people diagnosed with lung cancer in England in 2012.
13

Heart disease causes just under 61,000 deaths each year, yet there is little awareness that breathlessness is a serious cardiac symptom.
14

More than 750,000 people in the UK have heart failure 3 and of those admitted to hospital with
heart disease in 2012, almost 80% had moderate to severe breathlessness.
15

It is estimated that there are over 76,000 people with undiagnosed heart disease in the East
of England.
2
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5. Article templates
Please find some examples of copy below that you can use when communicating with your audiences about the breathlessness campaign in the East of England.
This copy can be used across a range of channels, for example, websites, e-bulletins, newsletters, or for social media purposes. Simply cut and paste this copy, add the relevant local information and share.
Short Copy – for email, bulletins and websites
New campaign in the East of England to raise awareness of ‘breathlessness’ in a bid to save lives
<Insert organisation/group name> is supporting Public Health England’s breathlessness campaign launching in the East of England.
The campaign is running across the East of England and aims to raise awareness of breathlessness as a symptom of lung and heart disease.
Those who get out of breath doing simple everyday activities, such as getting dressed, are encouraged to go to their GP as early diagnosis and treatment can save lives.
Many people in the East of England will be suffering from breathlessness but may not have seen their doctor yet. Instead, they will have developed coping mechanisms such as taking short breaks when working, giving up hobbies or not leaving the house as often.
For further information on breathlessness and the pilot campaign including a leaflet which is also available in alternative formats, please visit www.nhs.uk/outofbreath
Long copy – for more in-depth publications including newsletters
East of England residents are targeted to understand the importance of breathlessness
<Insert organisation/group name> is supporting Public Health England’s regional breathlessness campaign, aiming to raise awareness of one of the key symptoms of heart and lung disease (COPD).
The campaign is running across the East of England and encourages people to visit their doctor straight away if they have been experiencing breathlessness while doing everyday activities such as: o vacuuming o mowing the lawn o walking at normal pace (and struggling to keep up with friends) o moving from the sofa to make a cup of tea o dressing and undressing yourself o climbing short flights of stairs
The campaign sees adverts running in print and radio across the region while campaign materials, such as posters and leaflets, will be readily available in GP surgeries.
The overarching objective of the campaign is to encourage earlier presentation of excessive breathlessness to allow prompt treatment. This forms part of the government’s wider ambition to help
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reduce premature avoidable mortality and improve the lives of people with long-term conditions through earlier diagnosis.
For more information on breathlessness and the campaign including a leaflet which is also available in alternative formats, visit www.nhs.uk/outofbreath
6.
Social media
Please encourage your partners and contacts in the area to use their online channels to spread the message about the campaign.
Twitter: General campaign messaging
Suggested/sample Tweets
We are backing @PHE_uk #breathlessness campaign. Is light housework or walking a short distance getting you out of breath? See your GP www.nhs.uk/outofbreath
Join us and support the new campaign from @PHE_uk launching in the East of
England . Don’t ignore #breathlessness www.nhs.uk/outofbreath
Do you get out of breath doing things that you used to be able to do? If so tell your doctor #breathlessness www.nhs.uk/outofbreath
Getting older isn’t necessarily a reason to feel out of breath, so tell your doctor.
#breathlessness www.nhs.uk/outofbreath
Being overweight isn’t necessarily a reason to feel out of breath, so tell your doctor.
#breathlessness www.nhs.uk/outofbreath
Being short of breath could be a sign of something more serious – go see your doctor
#breathlessness www.nhs.uk/outofbreath
Breathlessness could be a symptom of chronic obstructive pulmonary disease (COPD), heart disease www.nhs.uk/outofbreath
Support the new @PHE_uk #breathlessness campaign. www.nhs.uk/outofbreath
It’s estimated that there are nearly 46,000 people with undiagnosed lung disease in the
East of England - early diagnosis can save lives #breathlessness
It’s estimated that there are over 76,000 people with undiagnosed heart disease in the
East of England - early diagnosis can save lives #breathlessness
Feeling breathlessness? This could be a sing of something more serious – visit your
GP #breathlessness www.nhs.uk/outofbreath
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Facebook: General campaign messaging
Suggested/sample posts
We’re supporting a new Public Health England campaign in the East of England, aimed at raising awareness of breathlessness as a symptom of conditions such as lung and heart disease
People who get out of breath doing simple everyday activities need to go to their doctor instead of trying to cope with it. www.nhs.uk/outofbreath for further information.
Join us and support the NHS breathlessness campaign. Post this as your status:
Are you or someone you know getting out of breath doing simple everyday activities like walking a short distance, doing light housework or gardening? Don’t ignore it and learn to live with it, see your doctor. Early diagnosis and treatment will help improve your life.
Find out more at www.nhs.uk/outofbreath
If you are feeling out of breath when doing day-to-day activities that you used to be able to do, then it could be a symptom of an illness such as lung or heart disease and you should visit your doctor.
Find out more at www.nhs.uk/outofbreath
Public Health England is launching a new breathlessness campaign in the East of
England to raise awareness that feeling out of breath when doing day-to-day activities that you used to be able to do, could be a symptom of something more serious, such as heart or COPD.
There are nearly 123,000 people registered with COPD and 229,000 registered with heart disease in the East of England.
Find out more at www.nhs.uk/outofbreath
Breathlessness is a key symptom for a number of conditions, such as lung disease and heart disease, which, if diagnosed early, are more treatable.
Breathlessness may involve: o Difficulty breathing o Uncomfortable breathing o Feeling like you are not getting enough air o More rapid breathing o Shortness of breath o Panic attacks
Find out more at www.nhs.uk/outofbreath
It is estimated that there are over 169,000 people living with COPD in the East of
England, but only around 123,000 have been diagnosed. Earlier diagnosis ensures that people with lung disease are given the right care and treatment that has the potential to slow down or modify the progressive nature of this condition.
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Find out more at www.nhs.uk/outofbreath
It is estimated that there is over 305,000 people living with heart disease in the East of
England, but only around 230,000 have been diagnosed. Earlier diagnosis ensures that people with heart disease are given the right care and treatment that has the potential to slow down or modify the progressive nature of this condition.
Find out more at www.nhs.uk/outofbreath
Social media advice

Please follow @PHE_uk and re-tweet messages where relevant

Use the #breathlessness hashtag in tweets where possible and encourage people to use the same – this will help the topic to ‘trend’ and appear on more feeds
7. Adverts
TV adverts have appeared on regional TV channels, on radio and in print publications. TV adverts will also be played in GP surgeries and print adverts will be printed onto pharmacy bags in the area.
The TV advert will show a boy mimicking his grandfather mowing the lawn, shot as if from a smartphone. Every now and again the boy stops and leans on his lawnmower for a rest and takes some deep breaths. Someone offscreen asks what he is doing and the boy says, “mowing the grass like granddad”. The grandfather at this moment realises that he may have a health issue, and visits his doctor.
Attitudinal research revealed that the campaign’s target audience is more receptive to encouragement from family members (and in particular children) to visit their GP. The advert brings this to life by depicting a child’s imitation of their grandfather’s breathlessness as the trigger that causes him to seek medical advice.
Print advert
The below print advert will feature across key regional titles.
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Other advertising
In addition, we are running advertising on GP TV screens and print adverts on pharmacy bags. As well as YouTube advertising and paid search.
Campaign materials and campaign support
The breathlessness leaflets and posters can be ordered free of charge from the Health and Social
Care Publications Orderline at
/ tel 0300 123 1002 using the following product codes. We would ask local teams to help distribute materials to libraries, community settings, local charities, pharmacies, Citizens Advice Bureaux and any other suitable venues. Or if you have links with local football or rugby clubs etc please ask them if they will display posters or run the adverts in their programmes or on their TV screens. If you would like further information on how you can help promote the campaign locally or engage local partners, please contact
2901839 BREATHLESSNESS PATIENT INFORMATION LEAFLET
2901974 BREATHLESSNESS PATIENT INFORMATION A4 POSTER
2901976 BREATHLESSNESS PATIENT INFORMATION A3 POSTER
2903093 BREATHLESSNESS PATIENT INFORMATION LEAFLET *NEW*
The mainstream leaflet has been produced in alternative formats, including Braille, audio, large print,
BSL and easy read. These can be downloaded at nhs.uk/outofbreath or hard copies can be obtained from enquiries@phe.gov.uk. For more information please contact barry@bdscommunications.co.uk
1 Found at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216139/dh_128428.pdf
2 Data calculated by PHE Knowledge and Intelligence Team East based on 2013-14 Quality and Outcomes
Framework (QOF) data and 2011 Modelled disease estimates
3 http://www.mims.co.uk/news/882327/Heart-Failure/
4 Health and Social Care Information Centre, October 2014 http://www.hscic.gov.uk/catalogue/PUB15751
5 Shahab L, Jarvis M J, Britton J, West R. Prevalence, diagnosis and relation to tobacco dependence of chronic obstructive pulmonary disease in a nationally representative population sample. Thorax 2006: 1043-
1047
6 BUPA.co.uk. Chronic obstructive pulmonary disease. Access via http://www.bupa.co.uk/healthinformation/directory/c/copd
7 (i) Currow DC, Plummer JL, Crockett A, Abernethy AP. A community population survey of prevalence and severity of dyspnea in adults. Journal of pain and symptom management. 2009; 38(4):533 – 45 and (ii) Bowden
J, To THM, Abernethy AP, Currow DC. Predictors of chronic breathlessness: a large population study. BMC public health. 2011; 11(1):33.
8 Ho SF, O'Mahony MS, Steward JA, Breay P, Buchalter M, Burr ML. (2001) Dyspnoea and quality of life in older people at home. Age Ageing. 2001 Mar;30(2):155-9
9 Office for National Statistics. Deaths Registered in England and Wales (Series DR), 2012. http://www.ons.gov.uk/ons/dcp171778_331565.pdf
10 Data provided by Public Health England, West Midlands Knowledge & Intelligence Team, on behalf of the
United Kingdom Association of Cancer Registries, May 2103
11 Consultation on a strategy for services for chronic obstructive pulmonary disease (COPD) in England.
Access via: http://www.dh.gov.uk
12 Office for National Statistics. Lung cancer incidence, mortality and survival, England, 1971 –2011. Access via: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/no--42--2011/stylung-cancer.html
13 http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/no--43--2012/infomost-common-cancers.html
14. NHS Choices. Coronary Heart Disease. Access via http://www.nhs.uk/Conditions/Coronary-heartdisease/Pages/Introduction.aspx
15 http://www.hqip.org.uk/assets/NCAPOP-Library/NCAPOP-2013-14/UCL-HF-2013-Report-2013-ONLINEv2.pdf
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