Table of contents


Adults :: COPD :: Summary

Chronic Obstructive Pulmonary Disease (COPD) is the name for a collection of diseases including chronic bronchitis, emphysema, and chronic obstructive airways disease. This condition is characterised by difficulty breathing, known as airflow obstruction, and can lead to profound difficulties carrying out the activities of daily life, and so a significantly impaired quality of life.

The airflow obstruction is usually progressive, not fully reversible (unlike in asthma) and does not change markedly for several months at a time. It is treatable, but not curable. Early diagnosis and treatment can slow down the progression of the disease and make it easier for individuals to carry out usual daily activities.

Smoking is the main cause of COPD. It usually affects people aged 35 and over who are or have been heavy smokers. Deprivation is linked to high smoking and COPD prevalence.

The total annual cost of COPD to the NHS is estimated to be over 800 million GBP for direct healthcare costs, which equates to 1.3 million GBP per 100,000 people.[1]

Key issues and gaps

The present way services are utilised in the treatment and management of COPD may not be cost effective, in particular the high rates of hospital admissions and of long-length hospital stays. For emergency admissions relating to COPD, the average length of stay is longer in Medway than other local comparators (7.9 days compared to an average of 6 days).[2]

Opportunities to reduce costs include:
• Compliance with NICE guidance [3] to support COPD patients who smoke to stop, by providing smoking cessation advice, and/or referring to stop smoking services.
• Compliance with NICE guidance to refer patients with an abnormally high or low body mass index (BMI) for dietetic advice, which may include referral to healthy weight or physical activity services.

Other gaps include:
• Low proportion of COPD patients who had a review and breathlessness assessment and low rates of FEV1 recorded compared to local comparators.[2]
• Lower proportion of COPD sufferers administered with the flu vaccination compared to local comparators.[2]


[1]   NICE. Chronic Obstructive Pulmonary Disease Costing Report---Implementing NICE guidance February, 2011; National Institute of Clinical Excellence. .
[2]   NHS RightCare. 2017;
[3]   NICE. Chronic obstructive pulmonary disease in over 16s: diagnosis and management June, 2010; National Institute of Clinical Excellence. .