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Transforming acute care in COPD

Why?

Three million people in the UK have COPD. When they have an exacerbation of their condition they need to have the right treatment as early as possible to minimise the acute and long term deterioration in their condition, and help them recover as quickly as possible. COPD is the second most common reason for admission to hospital and one of the most costly inpatient conditions to be treated by the NHS. With 94,000 admissions each year, it is important that that avoidable admissions are reduced, the inpatient stay is structured and streamlined and readmissions are avoided where possible.

What we’re doing

The ‘Transforming Acute Care in COPD’ workstream has three main focus areas:

  1. Reducing avoidable admissions and readmissions by increasing integrated care and supported self management
  2. Streamlining in-patient care for example through the implementation of care bundles, and the widespread availability of high quality specialist care
  3. Patient focused post-exacerbation follow-up integrated into long term condition management

By addressing these areas patient care in COPD will be improved which will result in increased access to specialist care, admissions avoided and reduced lengths of hospital stay so the patient is only in hospital for as long as is clinically indicated.

What we’ve found so far

  • Integrated care is essential to impact on numbers of avoidable admissions
  • Early supported discharge schemes expedite discharge from hospital. Early discharge services need evaluation and redesign to ensure they are achieving their intended outcomes
  • There is significant variation in LOS that cannot be explained by clinical factors. Processes to expedite discharge need to be put in place
  • Care bundles may be effective in streamlining the in-patient stay and discharge procedures

    • A small number of patients account for a large amount of resource with frequent, often clinically unnecessary admissions. Clearer definition and understanding of the health and social care needs of this group is important for better management.

    Next steps

    We now want to evaluate what are the most effective models for avoiding unnecessary hospital admissions, delivering streamlined care and ensuring integrated care throughout the inpatient stay and on discharge.

    More information



    For more information about transforming acute care, please contact:

    Catherine Thompson
    National Improvement Lead
    Lung Improvement Programme
    NHS Improvement
    Mobile: 0782 514 2815
    Email: catherine.thompson@improvement.nhs.uk