Care improved overall for COPD patients but some hospitals falling short
The Association of Respiratory Nurse Specialists and Royal College of Nursing (RCN) have today responded to the publication of the National COPD Programme Report, which examines the care of people with Chronic Obstructive Pulmonary Disease (which includes conditions such as emphysema and bronchitis).
Both organisations are pleased that care for patients with these conditions has improved overall, though concern remains that many patients are unable to access specialist support from respiratory nurse specialists who have unique expertise in helping patients to manage their conditions wherever possible.
Janet Davies, Director of Nursing at the RCN said:
“Nurses who work with patients with these serious and distressing conditions will be rightly pleased that their efforts have helped to improve care. However, we cannot overstate the importance of access to clinical nurse specialists, who can give exemplary support and treatment to both patients and other professionals. The focus has to be on helping patients to manage their conditions, and specialist nurses are the best to do this. It is very concerning that many patients cannot access specialist care when they need it”.
Rebecca Sherrington, Chair, Association of Respiratory Nurse Specialists, said:
“We are really pleased to see that this audit has demonstrated that there have been significant improvements in care for people with Chronic Obstructive Pulmonary Disease since 2008, including an improvement in the availability of palliative care services. The management of patients with respiratory failure has improved and there is better access to teams who can support an early discharge from hospital.
“However, we are disappointed to note that there has been a 9% drop in access to specialist respiratory care despite an increase in the number of people admitted with COPD. ARNS strongly supports the call for people with this disabling disease to be able to access expert nursing support to help manage their condition”.
The key findings from the report include:
- Above all else, COPD patients admitted with an exacerbation should be cared for by respiratory specialists on a respiratory ward, seven days a week.
- All Hospitals/Units should have a fully-funded and resourced smoking cessation programme delivered by dedicated smoking cessation practitioners
- All Hospitals/Units should make spirometry results accessible from every computer desktop; there should be a data sharing agreement between primary and secondary care that allows General Practice spirometry data to be made universally available.
- Post-discharge pulmonary rehabilitation services should be available within 4 weeks of referral.
- To improve local commissioning and service needs for COPD, audit data should be used to inform decisions and incorporated into local CQUINS to drive change.
The audit assessed the resources and organisation of COPD services against NICED quality standards for COPD.
Dr Robert Stone, COPD audit clinical lead for secondary care said,
“More patients have access to supported discharge teams and assisted ventilation services are better organised. However, many patients in England and Wales are still unable to access specialist respiratory care on the right ward from respiratory team. The availability of smoking cessation services and access to spirometry results (the key test of COPD) is inadequate. The way we manage patients’ discharge from hospital needs to improve”.
Professor Mike Roberts, lead national COPD audit programme said,
“We are pleased that many centres offer an absolutely first class service for COPD patients but we need to ask, is it acceptable in the 21st Century that patient experience and quality of care should be so variable? We know from previous audits that patients under the care of a respiratory specialist are more likely to receive evidence-based care and to benefit from specialist services such as supported discharge and pulmonary rehabilitation. We are calling for Hospitals to provide the expertise of respiratory specialist teams, seven days a week”.
You can read the report COPD: Who Cares? here