The COPD secondary care workstream comprised two parts: a continuous clinical audit of patients admitted to hospital in England and Wales with COPD exacerbations, and a snapshot audit of the organisation and resourcing of COPD care. A range of resources to assist in local implementation of the audit are also available.
On 1 March 2018, adult and paediatric asthma were added to the COPD audit programme when the National Asthma and COPD Audit Programme (NACAP) was launched.
Snapshot audits of clinical care along with organisation and resourcing were conducted in 2014 and, subsequently, both organisational and clinical national reports were published. A report detailing the clinical outcomes of the patients included in the 2014 audit was published in February 2017.
In 2017, the secondary care clinical audit moved to continuous data collection. Consecutive admissions from participating hospitals are being collected, and the data gathered from patient case notes are entered into a secure and bespoke web-based audit tool. Members of the clinical team and audit departments from each participating unit are able to enter data.
A snapshot organisational audit ran in 2017, with data collection via the bespoke web-based audit tool.
The datasets for each part of the audit have been developed and refined from the 2014 audit round, with effort made to reduce the burden on clinical teams. The final datasets are available to view. The clinical dataset focuses on:
The organisational dataset focused on the resources and organisation of care, and included a quality improvement element, with sites asked to submit action plans developed as a result of the last round of audit.
Participation in the COPD audit is a requisite of trust quality accounts. Guidance, help notes and patient information posters and leaflets have been produced for the audit period, and are available on this website; provisional versions of the datasets are available for download from our resources page.
The secondary care audit also has a programme page on the Respiratory Futures website, as well as a forum where healthcare professionals can share learning about doing and learning from the audit.
Two audit indicators within the clinical dataset form the basis of a COPD best practice tariff (within the National Tariff for 2017–18 and 2018–19). This was introduced in April 2017:
From late 2017 six key COPD metrics that are measured through the audit will be used by the Care Quality Commission (CQC) as part of the National Clinical Audit Benchmarking (NCAB) project to measure trust performance. The following hospital level data will be provided to the CQC on a 6-monthly basis regarding the percentage of patients receiving:
Each of the above metrics will be compared to an aspirational standard (either BPT attainment or upper quartile), as well as against national medians.
The above timeline may be subject to change but we will keep you updated regarding any changes and provide additional timeline details as they are confirmed.
All data that will be collected by the audit programme will be processed to ensure patient confidentiality is maintained.
This audit has been granted Section 251 approval by the NHS Health Research Authority (CAG reference: CAG 8-06(b)/2013), meaning that we are allowed to collect patient-identifiable data without patient consent. More information about the data items collected, as well as about the data flows outlined below, is available in our patient information sheet as part of the audit resources for the secondary care workstream.
Identifiable patient data will be entered into an online data collection tool managed by Crown Informatics from 1 February 2017 onwards. These data will be sent to the RCP at periodic intervals by Crown Informatics in a completely anonymised format for analysis and reporting. A national report, similar to the one published in 2014 (COPD: Who cares matters) will be published using these data, as will reports for Clinical Commissioning Groups (CCGs). Only aggregate data will be presented, and no information will be released that could be used to identify individuals.
The audit information will also be linked with data already held by NHS Digital: namely, the Hospital Episodes Statistics (HES) dataset and the Office of National Statistics (ONS) mortality data. HES is a record of all hospital admissions in England, while ONS mortality data is sourced from civil registration data. NHS Digital will receive patient identifiable information (NHS number, date of birth and postcode) from Crown Informatics to link the audit data to these sources. Once the data has been linked, it will be sent back to Crown Informatics, who will remove all patient identifiable information. The RCP will then be sent anonymised patient level records for the patients that participated in the audit from both HES and ONS (cause of death, and month and year of death will be provided to the RCP from ONS mortality data).
These data (ie audit data linked to HES and ONS) will be used to produce a supplement to the national clinical report. Only aggregate data will be presented and no information will be released that could be used to identify individuals.
Please note that the data collected for this audit may periodically be shared with other organisations in a completely anonymised format. Circumstances may include research, or for local quality improvement initiatives. Data will only be shared if appropriate legal approvals are in place, and no information that could be used to identify individuals will be released. Any such use of the data will always be in line with the overall aims of improving care and services for people with COPD.
If you think your data may have been collected as part of this audit and wish to have it removed, then please speak to a member of your respiratory team at the hospital that treated you, or contact a member of the audit programme team by email at email@example.com or phone on +44 (0)20 3075 1526.
The datasets for each part of the audit were developed and refined during 2013 by the workstream steering group, with input from the NHS and British Thoracic Society (BTS) COPD leads, and in light of feedback from a short pilot audit run in September 2013.
All relevant secondary care providers in England and Wales were expected to participate. The National COPD Audit Programme is included in the list of national audits for inclusion in trusts’ Quality Accounts, and is also included in the NHS Wales Clinical Audit & Outcome Review Plan.
The National COPD Audit Programme has been commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) and currently covers England and Wales only. We are very much aware that colleagues in Scotland and Northern Ireland may wish to audit their practice, and while this presents challenges in relation to resourcing and Information Governance rules that differ from country to country, the National COPD Audit team continues to explore ways in which this could be achieved in the future.