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National Asthma and COPD Audit Programme (NACAP): secondary care workstream - COPD

What we are doing

The COPD secondary care workstream comprises two parts: a continuous clinical audit of people admitted to hospital in England, Scotland (1 November 2018 until 6 November 2020)* and Wales with COPD exacerbations, and a snapshot audit of the organisation and resourcing of care. Participation in the secondary care workstreams of the National Asthma and COPD Audit Programme (NACAP) is a requisite of trust quality accounts.

*The Scottish Government, on behalf of NHS Scotland and other stakeholders, has been working with HQIP since November 2018 to try and identify a mutually agreeable legal basis that will support Scotland’s continued participation in the NCAPOP (which is a programme of a number of audits including NACAP), specifically around the financial payment for that participation.

Unfortunately, this has not been identified, resulting in withdrawal by the Scottish Government from paying to participate in the national clinical audits. This means that Scottish hospitals and pulmonary rehabilitation services in Scotland will no longer participate in the NACAP.

COPD - continuous clinical audit

The COPD continuous clinical audit was initiated under the auspices of the National COPD Audit Programme in February 2017. A new clinical report was published on 9 July 2020 which presents key process and short-term outcome measures for patients discharged from hospital between 1 October 2018 and 30 September 2019.

This audit aims to collect information on all people admitted to hospital with COPD exacerbations. Admission data, obtained from patient case notes, are being collected by participating hospitals, and the data entered into a secure and bespoke audit web tool. A partially revised dataset launched on 1 October 2018. The updated dataset has been published on both the web tool and the workstream resources page along with updated guidance documents. Please note these changes do not impact upon the best practice tariff (BPT).

COPD and adult asthma - organisational audit

A new organisational audit report was published in March 2020. The snapshot organisational audit collected data on the resourcing and organisation of services. It launched on 1 April 2019 and ran until 1 July 2019. In an effort to reduce clinical burden and duplication of effort this ran as a combined COPD and adult asthma organisational audit with data collection via the bespoke audit web tool

Best practice tariff (BPT)

Two audit indicators within the clinical dataset form the basis of a COPD best practice tariff (included within the national tariff for 2019–20). This was introduced in April 2017:

  • specialist review within 24 hours
  • BTS, or equivalent, discharge bundle for admission.

For all other uses of COPD audit data please refer to the 'uses of data' document which can be downloaded from the COPD audit resources page.

COPD secondary care good practice repository

The National Asthma and COPD Audit Programme (NACAP) has collated a series of case studies which highlight good practice in audit data collection and entry, and in provision of quality COPD care. These can be accessed via the dedicated good practice repository webpageThe 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.

Register to participate in the COPD workstream

Registration remains open. Hospitals in England and Wales who admit people with with COPD exacerbations are eligible to participate. If you would like further information about how to register your hospital for the audit, please contact us via copd@rcp.ac.uk or visit the workstream's resources page to download a copy of the registration form.

Workstream timelines

  • March 2018 – February 2021: continous clinical data collection
  • May 2019: 2017/18 COPD clinical audit report publication
  • April – July 2019: COPD and asthma adult organisational audit data collection
  • March 2020: COPD and asthma adult organisational audit report publication
  • July 2020: 2018/19 COPD clinical audit report publication

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.


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 copd@rcp.ac.uk or by phone on +44 (0)20 3075 1526.

Who's involved


All relevant secondary care providers in England and Wales, are expected to participate. NACAP is included in the list of national audits for inclusion in trusts’ quality accounts, and is also included in the NHS Wales clinical audit and outcome review plan.

What we have produced

NACAP COPD clinical audit report 2019/20 – Data and Methodology is the fourth clinical audit report to be published by NACAP since continuous data collection started on 1st February 2017. It details the care received by 38,084 patients who were discharged from 182 hospitals in England, Scotland and Wales between 1st October 2019 and 29th February 2020.

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.

The adult asthma and chronic obstructive pulmonary disease (COPD) organisational audit report 2019 is the first published organisational audit report following the launch of the National Asthma and COPD Audit Programme (NACAP) in March 2018.

COPD clinical audit 2017/18 is the second report post launch of continuous data collection on 1 February 2017.

Information and resources developed to help organisations participating in the NACAP secondary care (COPD) workstream.
The National Asthma and COPD Audit Programme (NACAP) has collated a series of case studies which highlight good practice in audit data collection and entry, and in provision of quality COPD care. 
England, Scotland and Wales case ascertainment for the COPD secondary care audit.