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Creating a vision for the future of COPD services

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Living with chronic lung disease can have many effects on patients, their carers and families.

It is not just about the disease process and medications; adapting to a long-term condition also means living with the disease and its consequences on a day-to-day basis forever. This illness burden can often result in psychological effects, in particular increased stress, anxiety and depression.

One patient group in particular that experiences a high psychological morbidity is those with COPD. This is now regarded as a highly complex disease that puts a great burden on individuals, healthcare systems and the wider economy. It is the recognition of this that has led to the first national clinical strategy being drawn up.

In 2006, the secretary of state for health announced that a national service framework should be developed for COPD. Since then, junior health minister Lord Darzi’s NHS Next Stage Review (Department of Health, 2008) has directed new policy towards development and implementation of clinical strategies. So the name has changed but the sentiment remains the same.

The COPD Clinical Strategy will outline a vision for COPD services in England. It will include setting quality requirements and markers of good practice across the disease pathway, providing guidance on the development of local services and outlining processes that consider how to implement and monitor these standards.

It is anticipated that the strategy will be published at the end of this year or early next year.

Promotion of standards for long-term care should lead to a more active approach to management, enabling regular review of individuals and use of pulmonary rehabilitation programmes.

This approach should in turn enable healthcare professionals to regularly review patients and identify problems, including psychosocial issues, in a timely manner that will instigate appropriate interventions.

It is hoped that the strategy will improve supportive care for patients and carers at all stages of the disease, including at the
end of life.

The COPD Clinical Strategy in itself may seem to focus on one disease area but, importantly, it is the first for the NHS and respiratory disease. So, while it has a specific name, it also provides the potential to focus attention on the common needs of all patients with chronic lung disease.

Carol Kelly, MA, BSc, RGN, is senior lecturer, Respiratory Education UK, Liverpool.

Department of Health (2008) High Quality Care for All: NHS Next Stage Review. Final Report. London: DH.

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