Core policy

In addition to IMPRESS guides, there are some key policy documents from:


NHS England

Dr. Martin McShane, Domain Director – Enhancing the quality of life for people with Long Term Condition, (Outcomes Framework Domain 2) announced in April 2013 the House of Care model that he wants person-centred, coordinated care that will enable individuals to make informed decisions which are right for them, and empower them to self-care for their own long term conditions in partnership with health and care professionals.

To deliver this "I want to use a framework to guide people’s thinking which we have called the ‘House of care.’ This has four components which all need to be in place if we are to deliver person centred, co-ordinated care:

DH England (up to April 2013)

  • NHS Outcomes Framework 2013 to 2014 – focus on measuring health outcomes. This  sets out the outcomes andcorresponding indicators that will be used to hold the NHS Commissioning Board to account for improvements in health outcomes, as part of the government’s mandate to the NHS Commissioning Board. This latest version of the framework builds on the previous two versions of the framework and contains measures to help the health and care system to focus on measuring outcomes. It describes how the NHS Outcomes Framework will work in the wider system, and highlights the indicator changes since the December 2011 edition.





NHS Companion Document published 11May 2012 (see blog 24)

The NHS Companion Document sets out 45 best practice actions to help medical professionals, commissioners and service managers to deliver across the five domains in the NHS Outcomes Framework for people with COPD and Asthma: to

  • Reduce mortality,
  • Improve quality of life
  • Help people recover from episodes of ill health
  • Deliver a positive patient experience
  • Avoid harm.

These actions draw on the Outcomes Strategy for COPD & Asthma, NICE clinical guidelines and the NICE Quality Standard for COPD.

The NHS Companion Document contains a detailed description and background information for each of the actions, including the case for change and links to the evidence base for the proposed action. The Companion Document includes information about how NHS actions relate to public health and social care, and details the levers for change to help ensure the actions are delivered by the NHS. There is also information about the implementation support available through professional bodies, patient charities and NHS organisations.

Alongside the full document, there is also a Summary Document and an Economic Impact Report which gives the financial case for change, showing how these actions can help the NHS meet its QIPP objectives.

A commissioning tookit was launched 2 August 2012 offering service specifications and economic modelling for four elements: case-finding, acute care, PR and home oxygen assessment and review.

Summary by PCRS-UK

PCRS-UK members can access further material here.


NICE has produced a range of resources to help commissioners and clinical teams to improve respiratory care and implement the NICE COPD Quality Standard.  This guide for commissioners highlights any recommendations supporting cases for disinvestment or decommissioning by identifying treatments and interventions that do not add value, enabling commissioners to release resources or generate savings where appropriate.

Read the interactive Commissioning guide for COPD

Download the Commissioning and Benchmarking tool for COPD services (Excel)

NICE has also produced a series of pathways covering the management of COPD in primary and secondary care. These include:
    •    A COPD overview pathway
    •    Diagnosing COPD
    •    Managing stable COPD
    •    Treating stable COPD
    •    Inhaled therapy in COPD
    •    Symptoms and conditions in stable COPD
    •    Managing exacerbations of COPD
These are available as an online resource that pulls together these 7 pathways.

Go to the NICE online COPD pathway web page 


Note that NICE now has apps to aid clinicians access its resources


The latest Payment by Results guidance: