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IMPRESS, a joint venture to improve and integrate respiratory services in the UK from its two leading respiratory professional bodies, Primary Care Respiratory Society-UK and British Thoracic Society welcomes the attention this report gives to COPD and the burden it places on patients and health services. We support clinicians and commissioners to reduce that burden by offering guidance and case studies that demonstrate the value of integrated care approaches along the pathway; the place of cost-effective treatments such as stop smoking and pulmonary rehabilitation as well as standards for the workforce. The report shows even more clearly that we need to see the COPD National Strategy published to guide improvement across the country in a consistent way. In terms of detail, we would recommend that commissioners double-check any analysis of data with local clinicians. Our knowledge of activity and coding would suggest that if you only look at the first entry on a coding form and if you are NOT using HRG4 you may miss a significant amount of COPD activity in hospitals such as DZ27 Respiratory failure and DZ22 'Unspecified Acute LRTI' that are often incorrectly used. Furthermore HRG version 3.5 still hid a lot of COPD in the 'Complex Elderly' code which may not be included in this analysis. For more free resources and guidance on respiratory care see:
MORE FOR LESS (guide to quality and productivity in respiratory services)http://www.impressresp.com/LinkClick.aspx?fileticket=xEgv-K-_-F0%3d&tabid=77
GUIDE TO INFORMATION ABOUT THE USE OF MEDICINES IN THE NHS
RATIONALISING OXYGEN USE TO IMPROVE PATIENT SAFETY AND TO REDUCE WASTE IN THE NHS
GUIDE TO RESPIRATORY CODING
IMPRESS GUIDE TO INFORMATION

all available on the IMPRESS website www.impressresp.com as listed on the Sg2 report