1. COPD off the shelf Scheme
LCRPCT
Dr Dave Briggs – Clinical lead
Tim Sacks – PBC management lead

2. Four Key Elements Practice Training needs Prevalence work
Strengthening primary care
Local Pulmonary Rehab and 02 Assessment

3. Practice Training Accredit Spirometry
Attendance of an accredited training course
Commissioned PLT across the localities
Clinical Audit (optimum patient care audit)
Peer review

4. Prevalence Work Should apply to 1% of the practice population
Criterion agreed between PCT and practices
Spirometry
If abnormal reversibility testing
Clinical review of the diagnosis

5. Strengthening Primary care
Improved PCT wide COPD template
Severity must be coded
Moderate and severe should have Biannually reviews
Use of the MRC breathlessness score
4+5 referral for pulmonary rehab

6. Pulmonary Rehab Each locality to have its own pulmonary rehab spoke.
Run by the provider arm of the PCT
Single point of access for severe patients under the care of the specialist respiratory nurse
Local 02 assessment service

7. Impact assessment Monitoring the take up of pulmonary rehab
Repeat the optimum patient care audit in one year
Monitoring the rates of admission and length of stay of the COPD HRG codes