Chronic obstructive pulmonary disease (COPD): policy context
There is an increasing policy focus on long-term conditions, both in Scotland and in the UK as a whole. COPD is recognised as an important long-term condition, but there is limited policy relating specifically to this disease.
The Scottish policy action plan Respiratory care - action plan: 2021 to 2026 sets out the government’s vision for driving improvement in the prevention, diagnosis, care, treatment and support of people living with respiratory conditions, which includes COPD. The priority areas included in the plan are prevention; diagnosis, management and care; supporting self-management; consistency across Scotland; workforce.
The Scottish Government's approach to long term conditions stresses the importance of self-management. The Self-directed support: improvement plan 2023 to 2027 advocates a generic (rather than disease-specific) approach to managing these conditions, including improving community care and self-management. The Scottish Government’s Strategic Framework for Action on Palliative and End of Life Care 2016-2021, set a vision, aims and objectives on this for that time period. The Palliative and end of life care: Strategy Steering Group, established in 2022, is overseeing the development and delivery of the palliative and end of life care strategy and associated work programmes in Scotland.
Audit Scotland published a report entitled Managing Long Term Conditions in August 2007. COPD and epilepsy were used as examples of long-term conditions and the report contains some useful analyses in relation to these conditions. It suggests that increased community care for COPD may reduce numbers of admissions, outpatient appointments and GP consultations (based on the experience of Scottish health boards), but the report suggested that the cost implications appear to be less well understood.
The European Respiratory Society first published International Comparison of COPD Care in Europe the end of 2010 and updated it in 2021. The comparison includes UK data.
Developed in 2017, the NHS RightCare COPD pathway (606kB) defines the core components of an optimal service for people with COPD in England. This includes timely access to pulmonary rehabilitation as part of the optimal treatment pathway and timely diagnosis as part of the pathway which help with early intervention measures. The National Asthma and COPD Audit Programme (NRAP) for England and Wales was launched in March 2018 and is led by the Royal College of Physicians. The aims of this programme are to improve quality of care, services, and clinical outcomes for patients with asthma and COPD by collecting and providing data on a range of quality improvement indicators.
Breathing well (1.2MB) is a state of the nation review of care for people with asthma and COPD in hospital, and for people with COPD accessing pulmonary rehabilitation. The report is compiled using data from 676 services in England and Wales that participated in NRAP between 2022-2023.
COPD was one of the conditions included in the Quality and Outcomes Framework of the 2023 General Medical Services contract.
In July 2011 the English Department of Health published An Outcomes Strategy for COPD and Asthma. No updates have been made.
Clinical guidance regarding the management of COPD (NG115 guideline) was produced by NICE (the National Institute for Health and Care Excellence) in 2018 and updated 2019. NICE also published a quality statement (QS10) regarding COPD in adults in 2011 (last updated in 2023), which covers assessing, diagnosing and managing COPD. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) publishes guidance on COPD.
Internationally, the World Health Organization has established the WHO Global Alliance against Chronic Respiratory Diseases (GARD). COPD is also included in the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases and the United Nations 2030 Agenda for Sustainable Development.
