NICE quality standards describe high-priority areas for quality improvement in a defined care or service area. Each standard consists of a prioritised set of specific, concise and measurable statements. NICE quality standards draw on existing NICE or NICE-accredited guidance that provides an underpinning, comprehensive set of recommendations, and are designed to support the measurement of improvement.
Expected levels of achievement for quality measures are not specified. Quality standards are intended to drive up the quality of care, and so achievement levels of 100% should be aspired to (or 0% if the quality statement states that something should not be done). However, this may not always be appropriate in practice. Taking account of safety, shared decision making, choice and professional judgement, desired levels of achievement should be defined locally.
Information about how NICE quality standards are developed is available from the NICE website.
See our webpage on quality standard advisory committees for details of standing committee 2 members who advised on this quality standard. Information about the topic experts invited to join the standing members is available from the webpage for this quality standard.
This quality standard has been included in the NICE Pathways on air pollution, physical activity, chronic obstructive pulmonary disease, chronic heart failure, asthma, stroke, hypertension and chest pain, which bring together everything we have said on a topic in an interactive flowchart.
NICE has produced a quality standard service improvement template to help providers make an initial assessment of their service compared with a selection of quality statements. This tool is updated monthly to include new quality standards.
NICE produces guidance, standards and information on commissioning and providing high-quality healthcare, social care, and public health services. We have agreements to provide certain NICE services to Wales, Scotland and Northern Ireland. Decisions on how NICE guidance and other products apply in those countries are made by ministers in the Welsh government, Scottish government, and Northern Ireland Executive. NICE guidance or other products may include references to organisations or people responsible for commissioning or providing care that may be relevant only to England.
This quality standard is expected to contribute to improvements in the following outcomes:
mean concentrations of nitrogen dioxide and particulate matter including PM2.5 and PM10
prevalence of cardiovascular disease
prevalence of respiratory disease
prevalence of lung cancer
A&E attendances (for respiratory and cardiovascular conditions)
hospital admissions (for respiratory and cardiovascular conditions)
mortality (from respiratory and cardiovascular conditions)
proportion of journeys by walking, cycling, public transport or zero- or ultra-low-emission vehicles.
It is also expected to support delivery of the Department of Health and Social Care outcome frameworks:
NICE quality standards should be achievable by local services. The potential resource impact is considered by the quality standards advisory committee, drawing on resource impact work for the source guidance. Organisations are encouraged to use the resource impact products for the source guidance to help estimate local costs:
During the development of this quality standard, equality issues were considered and equality assessments for this quality standard are available. Any specific issues identified during development of the quality statements are highlighted in each statement.
Commissioners and providers should aim to achieve the quality standard in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity and foster good relations. Nothing in this quality standard should be interpreted in a way that would be inconsistent with compliance with those duties.