The National Respiratory Audit Programme (NRAP)

The National Respiratory Audit Programme (NRAP) for England and Wales aims to improve the quality of care, services, and clinical outcomes for people with respiratory disease (including Asthma and COPD).

Spanning the entire patient care pathway, NRAP works closely with patients, as well as healthcare professionals, and aspires to set out a vision for services which puts patients' needs first.

It does this by using data to support and train clinicians, empowering people living with respiratory disease, and their carers, and informing national and local policy, with a strong track record of delivery, critical in assessing progress against national priorities.

Watch an introduction to NRAP by our senior clinical lead, Tom Wilkinson.

Submitting data to NRAP

Please note NRAP do not have information governance permission to view or receive patient identifiable data (including, but not limited to date of birth, NHS number and patient address). Please do not send NRAP any patient identifiable information. We will still assist with your query to the best of our ability.

If you require support in resolving specific import error queries, we advise that you contact the webtool provider Crown directly via helpdesk@crownaudit.org. Please do not send any data by email to Crown.

Data burden reduction

NRAP's data burden reduction strategy outlines how we're working to reduce the time, effort, and costs required for a provider to participate in our audits by collecting and submitting data. More information can be found in the HQIP Guidance for Data Burden Reduction.

Reports

View current and historical reports produced by NRAP, NACAP and the projects that proceeded them.

These include, clinical reports, organisational reports and outcomes reports.

Current NRAP reports

Past NRAP reports

Historic reports

Workstreams

Adult asthma secondary care workstream

COPD secondary care workstream

Children and young people’s asthma secondary care workstream

Primary care workstream

Pulmonary rehabilitation (PR) workstream

Healthcare quality improvement

Applying to work with NRAP data

Information governance

Patient involvement and support

NRAP team

The internal team consists of a number of project managers and coordinators that facilitate the programme workstreams. External support is provided by our clinical leads and fellows, data analysts based at Imperial College London and our Crown Informatics, our webtool technical team.

The NRAP governance structure consists of a Board, four workstream-specific Advisory Groups and two patient panels. Ad hoc steering groups also support programme work.

Members of these groups contribute to programme activities and decisions and, therefore, declarations of interests that may conflict with the audit programme are required as a matter of good governance:

NRAP board

The NRAP Board provides expert direction, operational oversight and performance management of the NRAP programme, and consists of stakeholders including patient representatives and national and patient organisations.

NRAP advisory groups

The advisory groups provides operational advice on the individual NRAP workstreams and consist of patients and healthcare professionals considered experts in their field.

The patient panels make sure the views, experiences and ideas of people affected by respiratory conditions, who use the NHS, can help shape the audit.

Information for patients and details about how NRAP works in partnership with patients and carers can be found on the patient involvement and support page.

We produce regular newsletters providing updates on NRAP and its workstreams. If you would like to receive the NRAP newsletter, or are already on our contact list and wish to be removed, email NRAPinbox@rcp.ac.uk.

NRAP outlier policy

NRAP published its refreshed outlier policy in September 2024.

This policy outlines how NRAP will identify, manage and communicate outliers across the programme, to improve participation and support healthcare quality improvement.

Our reports

Audit

14/11/24

NRAP organisational audit 2022-24

The NRAP organisational audit report 2024 details information on the resourcing and organisation of asthma and COPD care in hospitals, and PR services in England and Wales.

Report

12/09/24

Wales primary care clinical audit report 2021-23

This report presents results from an analysis of asthma and chronic obstructive pulmonary disease (COPD) primary care data in Wales from the Welsh primary care audit component of the National Respiratory Audit Programme (NRAP). Data were obtained from 359 general practices in Wales in February 2024 and capture activity between 1 August 2021 and 31 July 2023. This report includes five national recommendations relevant to key decision-makers and commissioners.

Report

11/07/24

Breathing well – clinical audit report 2022/23

Breathing well is a state of the nation review of care for people with asthma and COPD in hospital, and for people with COPD accessing pulmonary rehabilitation, between 2022-2023 in England and Wales. The report is compiled using data from 676 services in England and Wales that participated in NRAP. This report includes four national recommendations relevant to key decision-makers and commissioners.

01/02/24

Impact reports

NRAP exists to create a positive impact on the care of people living with respiratory conditions. Each year we publish a one-page impact report which looks at what impact we have achieved and how. The report can focus on either the national, local, system or public impact of NRAP. These impact reports are submitted to HQIP, our commissioners.

Report

13/06/23

Clinical outcomes summary report - 2018/20

The clinical outcomes summary report is the first combined outcomes report produced by NACAP. It presents information on the 30- and 90-day outcomes of 107,761 adults and 6,716 children and young people who were admitted to hospitals in England, Scotland and Wales for asthma or COPD and whose data were submitted to the NACAP adult asthma; children and young people asthma; or COPD secondary care audits between 2018 and 2020.

Report

28/02/23

Drawing Breath - clinical audit report 2021/22

Drawing Breath is the first ‘state of the nation’ report to combine data on asthma, COPD and pulmonary rehabilitation across primary and secondary care services to underpin key messages, optimising respiratory care across the pathway. This report includes recommendations for commissioners and providers, clinical teams and people with asthma and COPD, their families and carers.

Report

13/06/21

Wales primary care clinical audit report 2021

This report presents results from an analysis of asthma and chronic obstructive pulmonary disease (COPD) primary care data in Wales from the third round of the Welsh primary care audit component of the National Asthma and COPD Audit Programme (NACAP). Data were supplied by 314 (80.7%) general practices in Wales in October 2021 to capture a activity up to 31 July 2021.

The National Respiratory Audit Programme (NRAP)