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15/10/21

15 October 2021

National Asthma and COPD Audit Programme (NACAP): COPD clinical audit 2019/20

This report details the care received by 38,084 patients with acute exacerbations of COPD who were discharged from 182 hospitals in England, Scotland and Wales between 1st October 2019 and 29th February 2020.  This information is presented at national and country level for key processes and outcomes measures, including:

  1. Review by a member of the respiratory team,
  2. Oxygen prescription to a specified target range,
  3. Provision of non-invasive ventilation,
  4. Recording of smoking status and referral to smoking cessation.

Contributing to the overarching national quality improvement (QI) objectives of the NACAP, this report serves to empower stakeholders to use audit data to facilitate improvements in the quality of care. In addition to a full data analyses, the report contains recommendations for hospitals, commissioners, providers of primary care and patients, their families and carers, and outlines QI priorities for the delivery of COPD secondary care.

Key recommendations for hospital teams

Three key QI priorities for were defined in 2018 and these are presented again in this report to allow a continued focus on these important areas:

National QI priority 1: Ensure that all patients requiring NIV on presentation receive it within 120 minutes of arrival for those patients who present acutely. (BTS NIV QS4)4

National QI priority 2: Ensure that a spirometry result is available for all patients currently admitted to hospital with an acute exacerbation of COPD. (NICE [NG115] 1.1.4, NICE [QS10] statement 1)3 1

National QI priority 3: Ensure that all current smokers are identified, offered, and if they accept, referred to behavioural change intervention and/or prescribed a stop smoking drug. (NICE [NG115] 1.2.3, 1.2.4) 3

Download the full report for recommendations for commissioners and health boards, primary care providers, people living with COPD and more.

Impact of COVID-19 and NACAP reporting

This report covers a smaller patient cohort than previous outputs, and is not accompanied by supporting outputs eg national report, benchmarking or patient report. This is due to the decision taken by NACAP and HQIP not to report on any COVID-impacted data (recorded after 29 February 2020) or to produce comparative analysis on data where small cohort sizes may lead to misinterpretation.

Information on hospital performance against key indicators from 1 October 2019 – 31 March 2020  is provided in regional reports, available here.

COPD clinical audit 2019/20: 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.

COPD 2019-20 clinical audit - Hospital level data

This presents aggregated, hospital level data for all data items collected for the COPD 2019/20 clinical audit report. All data items are presented at national, country and hospital level according to the index in tab 1. The report highlights three key areas for quality improvement (QI) in 2019/20, presented in tab 2. Data relating to these areas are highlighted throughout the document.