Where to start
Consider a local needs assessment
Needs Assessments are a public health technique, where data from a number of sources are combined to build a useful overall picture of the quality, accessibility and demand for services.
We recommend sites consider producing a local report reviewing all data easily available, considering the big picture, and highlighting where there may be areas of variation or unmet need within the system.
It is important to recognise that this approach to data will give an overview and snapshot for a single point in time, and separate data will be required to give a view of ongoing change in practice and to manage performance.
The following questions have been suggested in the DH information packs, shared via NHS networks, as key questions to ask about service quality – and would be worth considering as part of a local needs assessment.
Is there a local programme of case finding for COPD:
- to ensure early diagnosis, to optimise proactive management and to minimise risk of expensive hospital admission
Do GP practices and community providers offer:
- quality-assured diagnosis
- support for self-management
- quality clinical review in line with NICE guidance
- appropriate referral for LTOT assessment and pulmonary rehab
- appropriate assessment and review of oxygen requirement
Do hospitals offer:
- access to specialist respiratory care
- early measurement of blood gas status and assessment for NIV
- optimal management of co-morbid conditions
- early supported discharge or hospital at home
The DH also recommends using the following measures to understand service variation.
Burden and detection
- Prevalence and gap between observed and expected prevalence
Admission rates
- Per 1000 COPD registered patients
- Hospital utilisation
- Emergency bed days/1000 PCT residents
- Quality indicators
- Readmission rates, hospital mortality
Cost
- Inpatient cost per 1000 population
Further information