National Asthma and COPD Audit Programme (NACAP): COPD clinical audit 2017/18

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COPD clinical audit 2017/18 is the second report post launch of continuous data collection on 1 February 2017. It presents key process measures including provision of timely review by a member of the respiratory team, oxygen prescription, provision of non0invasive ventilation, spirometry, recording of smoking status and prescription of smoking cessation pharmacotherapy, DECAF scores (an indicator of the risk of mortality in hospital) and discharge processes.

Key recommendations

For hospital teams

We defined three key QI priorities for 2018. They were chosen on a strong evidence base for their effectiveness in improving outcomes. These priorities still stand as there is still further improvement required: 

  • QI priority 1: Ensure that all patients requiring acute NIV on presentation receive it within 2 hours of arrival. (BTS NIV Q4)
  • QI priority 2: Ensure that a spirometry result is available for all patients admitted to hospital with an acute exacerbation of COPD. (NICE [NG115] 1.1.4, NICE [QS10] statement 1)
  • QI priority 3: Ensure that all current smokers are identified, offered, and if they accept, prescribed smoking cessation pharmacotherapy. (NICE [NG115] 1.2.3, 1.2.4)

For people living with COPD and their families and carers

  • Use the British Lung Foundation (BLF) COPD Patient Passport to understand whether you are receiving the care that you are entitled to and find out what to do if not. Take the patient passport to hospital with you if you are admitted.
  • Understand that important measures of care quality include being seen by a member of the COPD specialist team within 24 hours of admission, receiving a ‘discharge bundle’ prior to discharge (which typically includes advice and help to quit smoking), ensuring correct use of inhalers, referral to pulmonary rehabilitation and arranging appropriate follow up. Feel empowered to ask about these.
  • It can be diffcult for hospital teams to see and access results of breathing tests (spirometry) which you may have had at your GP surgery or in a different clinic. When you have breathing tests done ask for a copy of the results and keep these available should you be admitted to hospital.

For a full list of the recommendations see our downloadable national report .

Key short-term outcome measures included in this report are length of stay and inpatient mortality. Longer-term outcomes (30- and 90-day readmission and mortality) of this patient cohort will be published in an addendum and uploaded to this page once ready.

Results from the first national report conducted in 2017 and published in 2018 are also available.

For the first time, a patient friendly report has also been published to accompany this more detailed clinical report. This report presents key findings and recommendations for patients and their families and carers. It is available in the downloads section at the bottom of this page in an accessible format compatible with screen readers.

A quality improvement (QI) slide set, focused on the key findings from the 2017/18 clinical audit, is also available.

How to use this report

This report comes in two parts:

  • COPD clinical audit 2017/18: Audit report – this presents key findings, quality improvement opportunities and recommendations for hospital teams, primary care teams and commissioners/healthboards/sustainability and transformation partnerships (STPs).
  • COPD clinical audit 2017/18: Data analysis and methodology report – this contains the full data analyses from which the key findings and recommendations have been derived. The data are presented largely in tabular form, with explanatory notes throughout.

Please note that all appendices for this report, including the full methodology, can be found in the data report.

Downloads

COPD clinical audit 2017/18: Audit report

This report presents key findings, quality improvement opportunities and recommendations for hospital teams, primary care teams and commissioners/healthboards/sustainability and transformation partnerships

COPD clinical audit 2017/18: Data analysis and methodology report

This report contains the full data analyses from which the key findings and recommendations have been derived. The data are presented largely in tabular form, with explanatory notes throughout.

Benchmarked Key Indicators

This report shows unadjusted benchmarking of key indicators for participating hospitals in England and Wales.

COPD clinical audit 2017/18: Patient report, key findings for patients and carers

This report presents key findings, and recommendations for patients, their families and carers in a summarised and accessible format.

Quality improvement (QI) focused slide set

This slide set pulls together the key findings of the report, with a QI focus.

Data and variables

This presents aggregated, hospital-level data as used in the analysis for the COPD 2017/18 audit report. The data description file is an explanation of the variables found in the data file.