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National Asthma and COPD Audit Programme (NACAP): COPD clinical audit 2018/19

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COPD clinical audit 2018/19 is the third clinical audit report post launch of continuous data collection (on 1 February 2017). It presents data describing the cohort of patients discharged between 1 October 2018 and 30 September 2019. It presents key process measures including provision of timely review by a member of the respiratory team, oxygen prescription, provision of non-invasive ventilation, spirometry, recording of smoking status and referral to behavioural change invention and/or being prescribed stop smoking drugs for current smokers. Also, NEWS2 scores and discharge processes.

Contributing to the overarching national quality improvement (QI) objectives of the NACAP, it serves to empower stakeholders to use audit data to facilitate improvements in the quality of care.

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.

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, referred for behavioural change intervention and/or prescribed stop smoking drug. (NICE [NG115] 1.2.3, 1.2.4)

For people living with COPD and their families and carers

Recommendations for people living with COPD and their families and carers will be made available once the patient report for this cohort has been published.

How to use this report

This report comes in two parts:

  • COPD clinical audit 2018/19: 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)/integrated care systems (ICSs).
  • COPD clinical audit 2018/19: 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.

Supporting outputs

The report is accompanied by a QI slideset to inform and support services to deliver quality improvement initiatives based on report findings, and by a patient report which explains key findings and recommendations to patients, their families and carers.

Downloads

COPD clinical audit 2018/19: 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 2018/19: 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, Scotland and Wales.

Data and variables (Clinical audit 2018/19)

This presents aggregated, hospital-level data as used in the analysis for the COPD 2018/19 audit report. The data description file is an explanation of the variables found in the data file.

Quality improvement (QI) slide set

This slide set presents key findings from the report, recommendations for QI priorities and advice to services on how to implement these. COPD services are welcome to download these and share with their teams for information and training purposes.

COPD clinical audit 2018/19: Key finds for patients, carers and their families

This report summarises key findings and recommendations from the report for patients, carers and their families, to help them understand the care they should be receiving, and access the best possible care. A text-only version of the report is also provided for those who see differently; this is compatible with screen-readers.