National COPD Audit - Report from RCP

On World COPD Day the Royal College of Physicians (RCP) published a report looking at the clinical effectiveness of COPD care in primary care in England. - See HERE

The report, which follows publication of a Welsh primary care audit report last month, combines publically available data from 2014-15 for England with pertinent audit data extracted from Welsh general practices.

Data presented in this report echoes findings from the Welsh primary care audit that the accuracy of COPD diagnosis needs to improve and that some of the most clinically and cost-effective treatments for COPD, are being underutilised.

The report recommends:  

• A diagnosis of COPD should be made accurately and early. If the diagnosis is incorrect, any subsequent treatment will be ineffective.
• People with a confirmed COPD diagnosis should be offered treatment for tobacco dependency, targeted pharmacological treatment, and pulmonary rehabilitation that will improve their outcomes.
• People with more severe disease should be identified and prioritised for optimal therapy including referral for specialist review. A personalised approach is essential.
• Clinicians should improve coding and recording of COPD diagnosis, treatment and referrals. 

Dr Noel Baxter, PCRS-UK Chair and clinical lead for the primary care work stream said: ‘It will come as no surprise to people working in and with general practice who are interested in outcomes for people with COPD that the high achieving Quality and Outcomes Framework (QOF) results have provided false assurance about the quality of care for these people. Detailed, coded data from Welsh general practice has raised the alarm about how confident we can be about the metrics we are measuring and, subsequently, about what is actually happening in terms of the quality of diagnosis and the utilisation of the right interventions. Given the current inability to extract similar data for England, this report has sought to tell a story for England. We recommend CCGs urgently look at their local data following the concerns raised in Wales. It is time for England to be serious about measuring the quality of care for people with COPD.’

Action points:

• Read the report:  National COPD audit programme COPD in England- finding the measure of success can be downloaded HERE
• Consider how you could improve the quality of care provided to your own COPD patients by examining and reviewing current practices in one of the recommendation areas above – diagnosis, high value interventions, identification and prioritisation of patients with more severe COPD, and consistent coding

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