Combining specialist clinical care, diagnostics, multidisciplinary expertise, patient support, education and research to improve outcomes for people living with Chronic Pulmonary Aspergillosis.
The National Aspergillosis Centre (NAC) was established by NHS England to provide highly specialised care for people living with Chronic Pulmonary Aspergillosis (CPA), a serious fungal lung disease that can develop in patients with pre-existing respiratory conditions.
Over the last sixteen years the service has evolved into much more than a referral clinic. Today, NAC combines specialist clinical care, advanced diagnostics, multidisciplinary expertise, patient support, education and research, working alongside local healthcare teams throughout the UK.
Many clinicians are familiar with NAC as a specialist referral service. However, fewer may be aware of the breadth of support available through the centre, including specialist multidisciplinary team discussions, diagnostic expertise, physiotherapy, nursing support, pharmacy services, patient education programmes and nationally recognised fungal diagnostics.
This article provides an overview of how NAC supports both patients and healthcare professionals in the diagnosis and management of Chronic Pulmonary Aspergillosis.
“The National Aspergillosis Centre exists not only to care for patients with Chronic Pulmonary Aspergillosis, but also to support healthcare professionals throughout the UK in diagnosing and managing this complex condition.”
Contents
- Why specialist support matters
- What does NAC do?
- Working with local teams
- Benefits for patients
- Benefits for healthcare professionals
- Patient support and education
- Research, education and innovation
- Why awareness still matters
- Further resources
- Working together
Why specialist support matters
Chronic Pulmonary Aspergillosis (CPA) is a serious fungal lung disease that can develop in people with pre-existing respiratory conditions including bronchiectasis, Chronic Obstructive Pulmonary Disease (COPD), previous tuberculosis, sarcoidosis and other structural lung diseases.
Patients may present with chronic cough, breathlessness, fatigue, weight loss, recurrent chest infections or haemoptysis. These symptoms frequently overlap with more common respiratory conditions, making diagnosis challenging.
CPA remains a relatively uncommon disease and many clinicians may encounter only a small number of cases during their careers. As a result, specialist support can be valuable when diagnosis is uncertain, investigations are difficult to interpret or treatment becomes complex.
The National Aspergillosis Centre was established to provide that support.
What does the National Aspergillosis Centre do?
NAC is commissioned by NHS England to provide highly specialised care for patients with Chronic Pulmonary Aspergillosis.
The service supports patients through:
- Specialist assessment and diagnosis
- Multidisciplinary review of complex cases
- Long-term disease monitoring
- Antifungal treatment planning and optimisation
- Therapeutic drug monitoring
- Assessment and management of antifungal resistance
- Management of drug interactions and adverse effects
- Specialist physiotherapy support
- Specialist nursing support
- Access to clinical research and trials
Every new CPA diagnosis is reviewed within a specialist multidisciplinary team, helping to ensure a consistent and evidence-based approach to diagnosis and management.
NAC in 2023–24
- 209 referrals assessed for aspergillosis
- 101 new confirmed CPA diagnoses
- 311 patients under active specialist follow-up
- 71 external cases discussed through the National MDT
- 56 remote advice and guidance consultations
Working with local teams
One of the most common misconceptions about referral is that patients must transfer all of their care to Manchester.
In reality, NAC operates primarily through a shared-care model.
Wherever possible, investigations, imaging, monitoring and routine care are organised locally, with NAC providing specialist input and treatment recommendations. This approach allows patients to benefit from national expertise while remaining close to home.
The service also supports healthcare professionals through remote advice, specialist consultation and participation in the National Multidisciplinary Team (MDT) meeting.
For many clinicians, discussing a case through the MDT can help clarify diagnosis, identify additional investigations and support treatment decisions before or alongside formal referral.
Benefits for patients
Patients referred to NAC gain access to one of the world’s largest specialist CPA services.
Benefits include:
- Specialist review by clinicians with extensive experience in fungal lung disease
- Diagnostic clarification and confirmation
- Optimisation of antifungal therapy
- Management of treatment-related complications
- Access to specialist physiotherapy and nursing support
- Educational resources and self-management support
- Opportunities to participate in research
For many patients, specialist review provides reassurance, a clearer understanding of their condition and confidence in their treatment plan.
Benefits for healthcare professionals
The National Aspergillosis Centre exists not only to support patients, but also to support healthcare professionals.
Referral or specialist discussion may be particularly useful when:
- The diagnosis remains uncertain
- Radiological findings are difficult to interpret
- Patients are not responding as expected
- Antifungal toxicity develops
- Resistance is suspected
- A specialist second opinion would be valuable
Clinicians also gain access to expertise in therapeutic drug monitoring, antifungal stewardship, complex fungal diagnostics and long-term disease management.
Each referral creates opportunities for shared learning, helping local teams build experience and confidence in recognising and managing aspergillosis.
Patient support and education
One of the most distinctive features of the National Aspergillosis Centre is the support available beyond routine clinical care.
Many patients referred to NAC have experienced a long and sometimes frustrating journey to diagnosis. Symptoms may have been present for months or years before Chronic Pulmonary Aspergillosis is recognised.
Following diagnosis, patients are often faced with an unfamiliar condition and may encounter alarming information online that relates to very different forms of aspergillosis. It is therefore common for patients and families to feel anxious, isolated and uncertain about what the future may hold.
For this reason, patient support forms an important part of the NAC service.
Through the Community, Awareness, Research, Education and Support (CARES) programme, patients have access to:
- Regular patient support meetings
- Educational webinars and presentations
- Health and wellbeing sessions
- Patient newsletters
- Online information resources
- The Aspergillosis Patients and Carers website
- Peer support opportunities
One of the most common comments from newly diagnosed patients is the relief of discovering that they are not facing the condition alone. Meeting others living with aspergillosis and having access to trusted information can make a significant difference to confidence, understanding and long-term self-management.
“For many patients, finding the CARES programme is the moment they realise they are no longer facing aspergillosis on their own.”
By combining specialist clinical care with education, support and community, NAC aims to help patients and families feel informed, supported and empowered throughout their journey.
Research, education and innovation
The National Aspergillosis Centre works closely with the Mycology Reference Centre Manchester (MRCM), one of Europe’s leading specialist fungal diagnostic laboratories.
Together, NAC and MRCM contribute to:
- Clinical trials of new antifungal therapies
- Development of new diagnostic techniques
- Antifungal resistance surveillance
- National and international clinical guidelines
- Professional education and training
- Patient-centred research
The partnership has been recognised internationally through European Confederation of Medical Mycology (ECMM) Diamond Centre of Excellence status.
This close integration of clinical care, diagnostics, education and research helps ensure that patients benefit from the latest developments in fungal disease management.
Why awareness still matters
Chronic Pulmonary Aspergillosis remains an under-recognised disease worldwide.
Many patients present with symptoms that overlap with more common respiratory conditions such as COPD, bronchiectasis or previous tuberculosis. As a result, diagnosis can sometimes be delayed or missed.
This is not because clinicians are failing. CPA is an uncommon disease that can closely resemble more familiar respiratory conditions.
The role of NAC is therefore not simply to provide specialist treatment, but also to support earlier recognition of CPA through education, diagnostic support and collaborative working with healthcare professionals throughout the UK.
By raising awareness and improving access to specialist expertise, we hope to help more patients receive timely diagnosis, appropriate treatment and long-term support.
Further resources
- Aspergillosis Patients & Carers Website
- Chronic Pulmonary Aspergillosis Information Hub
- Patient Support Resources
- World Aspergillosis Day Resources
- Mycology Reference Centre Manchester
Working together
The National Aspergillosis Centre was established to ensure that patients with Chronic Pulmonary Aspergillosis have access to specialist expertise wherever they live.
Through shared-care working, multidisciplinary collaboration, specialist diagnostics, patient support, education and research, NAC continues to work alongside healthcare professionals throughout the UK to improve outcomes for people living with fungal lung disease.
Whether through referral, multidisciplinary discussion, specialist advice or educational resources, our aim remains the same: helping clinicians diagnose and manage aspergillosis with confidence while ensuring patients receive the support they need.
NAC is more than a referral centre. It is a national resource for patients, clinicians and healthcare services working together to improve the diagnosis and management of Chronic Pulmonary Aspergillosis.
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