NICE pathways

As well as its commissioning tools NICE has  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

Breathlessness pathway

As part of the 18-week referral to treatment programme, an 18-week breathlessness pathway was  launched by the Department of Health in England 4 December 2008.  "This is a pathway for patients who are breathless due to obstructive lung disease (the main diseases of which are COPD and Asthma).  It is intended to stimulate discussion between PCTs and providers to achieve seamless integrated care."

Obstructive lung disease (breathlessness) pathway is available to download as pdf here.

It is also available to view in a seperate window here

The interactive version is accessed here

Supplementary information is also provided here
To be clear, this is NOT a breathlessness pathway for all patients with breathlessness, but only those with COPD.
We welcome discussion from colleagues about how this is being used locally to stimulate discussion, and particularly about when it is used, rather than primary care management.

Map of Medicine also offers a suspected COPD pathway that is offered via the NHS Choices website.  Click here.



There is also a sleep disorders (adult) pathway that is similarly designed to be used for local discussions (available to download as pdf here).  It is also available to view in a seperate window here

The 18-week programme page is here.

The 18-week website gives many examples of how to develop and improve the pathway including general good practice guidance and information about commissioning and contractual levers and technology support.

Pathways reproduced with kind permission of NHS 18 weeks programme.   Pathway template design copyright © S Laitner and S Normanton 2007 at, all rights reserved