Diagnosing and Treating Chronic Obstructive Pulmonary Disease (COPD)

COPD is a common, preventable and treatable lung disease that develops as a result of exposure to noxious particles (most commonly tobacco smoke) over time in predisposed individuals. People with COPD typically experience persistent and often progressive symptoms, including shortness of breath, cough and sputum production. In addition, people with COPD are prone to episodes of rapid symptom worsening, termed exacerbations that frequently require support from acute healthcare services.

Over 42,000 people in Humber and North Yorkshire have been diagnosed with COPD, reflecting a higher prevalence than the England average, and many more people are living with the symptoms of COPD but have not yet been diagnosed. The rate of emergency hospital admissions with COPD are also higher in HNY than the England average. There is therefore opportunity to improve outcomes for people living with COPD in the region.

The Humber and North Yorkshire (HNY) Respiratory Network are passionate about ensuring that everyone with COPD across the region can access equitable, high-quality and sustainable care. The network aims to drive improvements in COPD care in order to improve outcomes for all people living with COPD in HNY, including reducing their risk of COPD exacerbation and hospitalisation. Click the drop down below to find out more on our COPD guidelines.

COPD Guidelines

The HNY Respiratory Network have worked with clinicians, commissioners and patients from across the region to develop a unified guide to managing COPD. These guidelines are intended to provide system-wide, evidence-based guidance on the diagnosis and management of COPD. They consist of a series of quick-reference summary guides that are complemented by a comprehensive guideline document. Aligned with national and international guidance, incorporating the latest evidence, and developed with regard to the local healthcare context, the guidelines have potential to support clinicians to provide and patients to access high quality treatment for their COPD.

The following COPD guidelines are intended for use by clinicians working in Humber and North Yorkshire and have been developed to inform:

Diagnosis of COPD
Management of COPD (non-pharmacological and pharmacological)
Management of Common COPD related Co-Morbidities

Quick Reference COPD Guides

Full COPD Guideline document

Humber and North Yorkshire COPD Service Signposting

The HNY Respiratory Clinical Network have compiled the following local services to support clinicians with the management of COPD patients. Click the drop downs below for more information.

Pulmonary Rehabilitation

Pulmonary Rehabilitation is an exercise and education programme designed for people with a lung condition which makes them breathless. There are seven Pulmonary Rehabilitation services across Humber and North Yorkshire:

York and Scarborough Teaching Hospitals
Harrogate and District NHS Foundation Trust
Humber Teaching NHS Foundation Hospital (Scarborough, Ryedale & Whitby)
South Tees Hospital NHS Foundation Trust (Hambleton and Richmond)
City Health Care Partnership (Hull and East Riding)
BOC Community Respiratory Service (Northern Lincolnshire)
HOPE Respiratory Service (North East Lincolnshire)

Who should be referred for Pulmonary Rehabilitation?

PR should be offered to all people with COPD who are functionally disabled by their symptoms (typically mMRC >= 2). The specific referral criteria for Pulmonary Rehabilitation varies by service. Service websites and referral forms can be found below:

NHS Talking Therapies

Talking therapies are treatments for mental health conditions delivered by trained professionals through talking and other methods.

There are six Talking Therapy services across Humber and North Yorkshire:

You can find your local service by clicking here.

How to refer to Talking Therapies?

Patients can access Talking Therapies through self-referral. Across Humber and North Yorkshire, the referral criteria is generally as follows:

Patients should be aged 17 or over and registered with a GP within Humber and North Yorkshire.
Patients should not be in crisis and in need of urgent help today.
Patients should not be under the care of existing Mental Health Services (For example, Crisis Team, Integrated Community Teams, Psychiatry, Psychology).
Managing anger should not be the main problem they are seeking help with.
Drug and/or alcohol misuse should not be the main problem they are seeking help with.

Stop Smoking Services

Stop smoking services are free, local resources that provide support and guidance to help people quit smoking.

An interactive map of local stop smoking services can be found on the Yes to Quit website.

How to refer to Stop Smoking services?

For specific information about referral criteria and how to refer, use the links in the map to visit the local stop smoking webpages.

Home Oxygen

Home oxygen services provide medical-grade oxygen to patients in their homes.

There are 3 forms of home oxygen therapy that are used for people with COPD: Long Term Oxygen Therapy (LTOT), Ambulatory Oxygen Therapy (AOT) and Palliative Oxygen Therapy (POT). More information on the different forms of home oxygen therapy can be found in the HNY COPD guidelines.

The Humber and North Yorkshire Home Oxygen services are:

City Health Care Partnership (Hull and East Riding)
Humber Teaching NHS Foundation Hospital (Scarborough, Ryedale & Whitby)
Harrogate and District NHS Foundation Trust (Harrogate and District)
York and Scarborough Teaching Hospitals (Vale of York)
South Tees Hospital NHS Foundation Trust (Hambleton and Richmond)
BOC Community Respiratory Service (Northern Lincolnshire)
Northern Lincolnshire and Goole NHS Foundation Trust (North East Lincolnshire)

Who should be referred to home oxygen services?

The inclusion/exclusion criteria for home oxygen services across Humber and North Yorkshire is generally as follows:

Inclusion criteria

Patients 18 years of age and over.
Patients with resting oxygen saturations ≤92% on room air persistently when clinically stable (LTOT).
Patients with oxygen saturations dropping > 4% on exertion (to ≤90%) (AOT) when clinically stable and active outside.
Patients with clinical evidence of Polycythaemia (Haematocrit >55%) and/or Pulmonary Hypertension with resting oxygen saturations ≤94% on room air persistently when clinically stable.
Palliative care patients.
Patients who are fully optimised with advice and appropriate medicines.

Exclusion criteria

Current smokers including e-cigarettes/vaping (Please refer to smoking cessation, reconsideration for oxygen when 3/12 smoke free) ref NICE 2023
Patients condition not fully optimised.
The service is not an emergency response service for patients who require oxygen therapy for acute episodes of illness.
Patients under 18 years of age.

If any information on this page is out of date, please contact hcvcommunitycollab.pmo@nhs.net.