Clearing the air – National study of COPD Health Care Commission 2006

Clearing the air National study of care and treatment available for people with COPD in England National study of care and treatment available for people with COPD in England Part of wider programme of work focussing on long term conditions/chronic disease Part of wider programme of work focussing on long term conditions/chronic disease Literature review, stakeholder consultations, specialist advisors, examined hospital activity, focus groups, specific aspects of services. Literature review, stakeholder consultations, specialist advisors, examined hospital activity, focus groups, specific aspects of services.

Key challenges Improve diagnosis of COPD – reduce misdiagnosis and undiagnosis. Improve diagnosis of COPD – reduce misdiagnosis and undiagnosis. Greater emphasis by PCTs on structured care for COPD. Greater emphasis by PCTs on structured care for COPD. Helping people to help themselves. (pul rehab) Helping people to help themselves. (pul rehab) Reducing admissions Reducing admissions Addressing poor prognosis Addressing poor prognosis Addressing individual needs Addressing individual needs Appropriate treatment for exacerbations Appropriate treatment for exacerbations Access to supportive and palliative care. Access to supportive and palliative care.

Facts about COPD 900,000 people diagnosed with COPD in the UK and an estimated 2million undiagnosed. 900,000 people diagnosed with COPD in the UK and an estimated 2million undiagnosed. Causes more than 30,000 deaths per year in UK Causes more than 30,000 deaths per year in UK 1.4million GP consultations/year 1.4million GP consultations/year 1 in 8 emergency admissions (second largest cause of emergency admission) 1 in 8 emergency admissions (second largest cause of emergency admission)

National recommendation More meaningful indicators to measure the outcome of care for people with COPD need to be developed and monitored routinely. More meaningful indicators to measure the outcome of care for people with COPD need to be developed and monitored routinely.

Local recommendations 1. PCTs as commissioners of services should lead improvements in care 2. Strategy should focus on areas of greatest social deprivation 3. PCTs should ensure fair access to care by improving accuracy and timeliness of diagnosis in primary care. 4. Explore options for improving support at time of diagnosis ( written info/ support gps)

Local recommendations 5. Respiratory networks should establish models of structured care in community. 6. PCTs with high rates of emergency admission should work with hospital teams to review management of these patients 7. Develop new initiatives to reduce admission and length of stay. 8. Improve and monitor access to pul rehab. 9. Monitor access to and provision of palliative care for non-malignant disease.

What will the HCC do next? 1. Assess and report on performance in relation to indicators for the implication of NICE guidelines for COPD 2. Assess and report on progress by trusts in meeting targets to reduce emergency bed days, and reduce smoking rates. 3. Report on improvement reviews of tobacco control and LTC. 4. Follow up local concerns about performance 5. Work with DOH to develop improved quality indicators for COPD.