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National COPD Audit Programme: pulmonary rehabilitation workstream 2013–18

What we are doing

The COPD pulmonary rehabilitation (PR) workstream comprises snapshot clinical and organisational audits of PR services across England and Wales.

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.

  • The pulmonary rehabilitation audit 2017 ran a snapshot audit of organisation and resources of pulmonary rehabilitation services, as well as a snapshot audit of clinical care. These took place concurrently in the first half of 2017.
  • Data was collected using the bespoke web-based audit tool.
  • Registration and recruitment took place in the autumn of 2016. If you know of any services that did not participate in the last round of audit, then please ask them to contact the National COPD Audit Programme team. A full list of participating services from 2015 is available in our reports and on the resources page.
  • The datasets have been refined from those used in the 2015 audit round, with effort made to reduce the burden on teams. The final datasets have been made publicly available on our resources page.
  • Guidance, help notes and patient information posters and leaflets have also been produced for the audit, and are available to download from our resources page.

Pulmonary rehabilitation: An exercise in improvement presents combined clinical audit (conducted between 3 January and 28 April 2017) and organisational audit (conducted between 3 January and 31 March 2017) data. A quality improved (QI) focused slide set is also available.

This report succeeds the 2015 clinical audit report published in February 2016 and the 2015 organisational audit report published in November 2015. A report detailing the clinical outcomes of the patients included in the 2015 audit was published in December 2017.

An interactive map of all pulmonary rehabilitation services and sites included in the 2017 audit is also available to view.

Workstream timeline

  • until December 2016: mapping and recruitment of audit sites in England and Wales
  • January 2017 until mid-July 2017: data collection period
  • 1 February 2017: launch of interactive map
  • July 2017 until October 2017: data analysis
  • autumn 2017: organisational and clinical service level reports to participants
  • winter 2017/18: publication of national organisational and clinical audit reports.

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.

Data processing

All data collected by the audit programme will be processed to ensure patient confidentiality is maintained.

This audit operates under a consent model, meaning that patients are required to provide informed consent prior to their data being collected and processed (to see the consent form and patient information sheet, please go to the resources section).

Identifiable patient data will be entered onto an online data collection tool managed by Crown Informatics between 3 January 2017 and  31 July 2017.  Once the data collection period has ended, Crown Informatics will send these data to the RCP in a completely anonymised format for analysis and reporting.  A national report, similar to the one published in 2015 (Pulmonary rehabilitation: Steps to breathe better) will be published using these data.  Only aggregate data will be presented, and no information will be released that could be used to identify individuals.

The next stage in this process will be to link the audit information (collected in the method outlined above) 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 and will use this 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 the 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 (at a national level) 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 have consented to your data being collected for this pulmonary rehabilitation audit and wish to revoke your consent, please either tell your pulmonary rehabilitation team or contact a member of the audit programme team by email copd@rcplondon.ac.uk or phone +44 (0)20 3075 1526.

For more information on the programme's data flows please read the patient leaflet on the audit resources page.

Who's involved


What we have produced

The 2015 round of time-limited data collection related to service provision and delivery of pulmonary rehabilitation services for COPD in England and Wales.
This report presents the findings from the snapshot pulmonary rehabilitation organisational and clinical audits conducted across England and Wales in 2017.  
'Pulmonary rehabilitation: Beyond breathing better' is a supplementary report detailing the outcomes of the English cohort of patients included in the 2015 pulmonary rehabilitation clinical audit.

This is the second of the COPD Pulmonary Rehabilitation audit reports, published as part of the National COPD Audit Programme, detailing national data relating to Pulmonary Rehabilitation delivered in England and Wales.

This audit report on the resources and organisation of PR services is the first comprehensive national audit of PR provision anywhere in the world, and it offers insight into the quality and quantity of provision of 224 programmes.

Tools to help organisations participating in the national COPD pulmonary rehabilitation audits navigate the audit process.

Site-level data as used in the analysis presented within the national pulmonary rehabilitation clinical and organisational audit 2017 report.