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Background and Context

The NHS Institute for Innovation and Improvement has identified COPD as one of 19 conditions where there is demonstrable evidence for ambulatory care and a reduction in admission to hospital of between 20 – 30% if best practice guidelines were universally adopted by health communities. The National Strategy for COPD is due for publishing in Autumn 2010 which sets out the government’s strategy to support people with respiratory illness to live healthy lives and to receive specialist care in an environment closer to their needs. The White Paper ‘Our Health, Our Care, Our Say: a new direction for community services,’ released in 2006, lays out the Government’s vision for community-based care. In order to achieve this, people will look for greater flexibility in service provision, improved accessibility, more timely interventions, a broader range of service providers from whom they can choose their care, and care closer to home with minimal disruption to their daily lives which is supported by Lord Darzis ‘High Quality Care for All’ paper following the ‘NHS Next Stage review’ (2007). This all requires a significant ‘shift’ in the way care is delivered, away from a reactive ‘one size fits all’ approach, often delivered in a hospital setting, towards a community based, responsive, adaptable, flexible service. Emergency admissions are forecast to rise by 1.5% per annum due to the aging population alone. The most common causes are chest pain, chest infections, Chronic Obstructive Pulmonary Disease (COPD) and asthma. Where health communities have community COPD services targeted at supporting patients within the community and minimising lengths of stay in hospital, the number of emergency admissions for people with respiratory disease has reduced by at least 20%. The Kirklees respiratory Health Improvement Teams commissioning plan sets out to commission a service for people with COPD that will deliver improved services and health outcomes for patients; and ensure an integrated approach across the Kirklees health community. The main outcome will be to minimise avoidable admissions to hospital and to improve service consistency, delivery and access for people with COPD in a cost-effective manner, whilst upskilling the Primary Care workforce in the management of COPD.