Quality standard

List of quality statements

List of quality statements

Statement 1 People aged over 35 years who present with a risk factor and one or more symptoms of chronic obstructive pulmonary disease (COPD) have post‑bronchodilator spirometry. [2011, updated 2016]

Statement 2 People with COPD who are prescribed an inhaler have their inhaler technique assessed when starting treatment and then regularly during treatment. [2011, updated 2016]

Statement 3 People with stable COPD and a persistent resting stable oxygen saturation level of 92% or less have their arterial blood gases measured to assess whether they need long‑term oxygen therapy. [2011, updated 2016]

Statement 4 People with stable COPD and exercise limitation due to breathlessness are referred to a pulmonary rehabilitation programme. [2011, updated 2016]

Statement 5 People admitted to hospital for an acute exacerbation of COPD start a pulmonary rehabilitation programme within 4 weeks of discharge. [2011, updated 2016]

Statement 6 People receiving emergency oxygen for an acute exacerbation of COPD have oxygen saturation levels maintained between 88% and 92%. [new 2016]

Statement 7 People with an acute exacerbation of COPD and persistent acidotic hypercapnic ventilatory failure that is not improving after 1 hour of optimal medical therapy have non‑invasive ventilation. [2011, updated 2016]

Statement 8 (Placeholder) Hospital discharge care bundle. [new 2016]

In 2016 this quality standard was updated, and statements prioritised in 2011 were updated (2011, updated 2016) or replaced (new 2016). For more information, see update information.

Statements from the 2011 quality standard for COPD that are still supported by the evidence may still be useful at a local level:

  • People with COPD have a current individualised comprehensive management plan, which includes high‑quality information and educational material about the condition and its management, relevant to the stage of disease.

  • People with COPD have a comprehensive clinical and psychosocial assessment, at least once a year or more frequently if indicated, which includes degree of breathlessness, frequency of exacerbations, validated measures of health status and prognosis, presence of hypoxaemia and comorbidities.

  • People with COPD who smoke are regularly encouraged to stop and are offered the full range of evidence‑based smoking cessation support.

  • People who have had an exacerbation of COPD are provided with individualised written advice on early recognition of future exacerbations, management strategies (including appropriate provision of antibiotics and corticosteroids for self‑treatment at home) and a named contact.

  • People with COPD receiving long‑term oxygen therapy are reviewed in accordance with NICE guidance, at least annually, by a specialist oxygen service as part of the integrated clinical management of their COPD.

  • People admitted to hospital with an exacerbation of COPD are cared for by a respiratory team, and have access to a specialist early supported‑discharge scheme with appropriate community support.

  • People admitted to hospital with an exacerbation of COPD are reviewed within 2 weeks of discharge.

  • People with advanced COPD, and their carers, are identified and offered palliative care that addresses physical, social and emotional needs.

The 2011 quality standard for COPD is available as a pdf.