Chronic obstructive pulmonary disease (COPD): policy context
There is an increasing policy focus on long-term conditions, both in Scotland and in the UK as a whole. COPD is recognised as an important long-term condition, but there is limited policy relating specifically to this disease.
The Scottish policy documents Delivering for Health (2005) and the Better Health, Better Care:Action Plan (2007) both recognised the importance of long-term conditions. Policy has tended to advocate a generic (rather than disease-specific) approach to managing these conditions, including improving community care and self-management.
The Scottish Government's approach to long term conditions stresses the importance of self-management. The Government's palliative care action plan (Living and Dying Well) is also relevant to the care of people with advanced COPD.
Audit Scotland published a report entitled Managing Long Term Conditions in August 2007. COPD and epilepsy were used as examples of long-term conditions and the report contains some useful analyses in relation to these conditions. It suggests that increased community care for COPD may reduce numbers of admissions, outpatient appointments and GP consultations (based on the experience of Scottish health boards), but the report suggested that the cost implications appear to be much less understood. The Royal College of Physicians published a UK wide COPD audit in December 2008 (the National COPD Resources and Outcomes Project - NCROP), which covered the organisation and delivery of care. The European Respiratory Society published International Comparison of COPD Care in Europe at the end of 2010, which included UK data.
COPD is one of the conditions included in the Quality and Outcomes Framework (QOF) of the new General Medical Services contract.
In July 2011 the English Department of Health published An Outcomes Strategy for COPD and Asthma.
Clinical guidance regarding the management of COPD (CG101) was produced by NICE (the National Institute for Health and Clinical Excellence) in 2010 and by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), with updates in 2014 and 2016. The British Thoracic Society published a guideline on pulmonary rehabilitation in September 2013.
Internationally, the World Health Organization has produced a 'Strategy for the prevention and control of chronic respiratory diseases' (WHO) (113Kb) and established the WHO Global Alliance against Respiratory Diseases (GARD).