Area Prescribing Committee COPD Guidance
Follow link for local prescribing guidance
Management Principles
- Offer pneumococcal and influenza vaccinations
- Encourage all patients to stop smoking
- Refer for oxygen assessment when O2 saturations are less than or equal to 92% breathing air
- Refer to pulmonary rehabilitation when Medical Research Council (MRC) dyspnoea score is 3
- Promote use of self management plans and rescue packs.
- Rescue packs could include: Doxycycline 200mgs stat then 100mg daily 6 days or Amoxicillin 500mgs three times daily for 7 days and Prednisolone (plain) 30mgs daily for 7 days
- Screen for anxiety and depression
- Consider referral to the rest of the multidisciplinary team e.g. community matron, community COPD service, physiotherapists, dietician (follow current CCG malnutrition guidelines if BMI is low), occupational therapy, social services, palliative care teams
Smoking Cessation
Smoking cessation services are delivered in GP surgeries and also by other providers (Any Qualified Provider).
Pulmonary rehabilitation
Does your patient have a confirmed diagnosis of COPD? Would they benefit from pulmonary rehab? Sessions are held at Atrium Health, Unit 1 Watch Close (off Spon Street), Coventry, CV1 3LN.
Available for patients across Coventry & Rugby (but transport is not available from Rugby)
Helps the patients:
- Feel less breathless and understand condition better
- Improve confidence and coping strategies
- Help recognise and cope with chest infections
- Learn about drugs and inhalers and ensure they are working
- Improve walking distance and stamina
The class runs on Monday and Thursday afternoons, 13:30-15:30. Most patients attend twice per week but there is some flexibility.
It is run in small groups and each session is split into 2 parts:
13:30—Informal discussions/talks on a variety of topics to help you learn more about your lungs, breathing, and treatment.
14:30—Exercise in a safe environment with health professionals on hand to help.
Atrium has started a Vascular and a Heart Failure Group offering a more functional, strength and balanced based class for more significantly disabled patients
Referral Forms
The Pulmonary Rehab referral form is available to download – see link right. Referrals cannot be accepted without a confirmed COPD diagnosis; full referral criteria are explained on the form. Completed forms are to be emailed to uhc-tr.covprreferrals@nhs.net
Please ensure practice nurses are aware of this service.
Oxygen
Please visit the GP Gateway Oxygen page for more information.
Coventry Guidance 
Coventry Community COPD Service
Referrals:
Patients registered with a Coventry GP with a confirmed diagnosis of COPD.
Referrals may be appropriate at ALL stages of the disease when clinically indicated and / or where specialist advice is required.
Referrals are accepted for patients with COPD in both a stable phase and during acute exacerbation (see Acute Exacerbation of COPD Pathway for referral criteria).
We offer both clinic-based and domiciliary assessment as required.
The following information is required when referring a patient:
- Spirometry (graph desirable)
- Pulse oximetry
- MRC Dyspnoea Score
- Most recent Chest X-Ray
- Past medical history
- Current medication (including oxygen)
- Full Blood Count
For queries, please contact the Community COPD Service directly.
Contact:
Fiona Shally, Lead Nurse, Community COPD Service
Dr J. Bhat, Consultant in Respiratory Medicine
Telephone: 02476 237005
This service is available on the NHS eReferral Service. Specialty: Respiratory Medicine Clinic Type: COPD. The service is setup as a Referral Assessment Service, so all referrals will be reviewed before an appointment is allocated.
Acute Exacerbation COPD – Community Pathway
The Community COPD service is available to support primary care in the management of COPD patients during an acute exacerbation.
Availability:
- Monday – Friday 09:00 -17:00
- Saturday and Sunday 09.00 – 12.45 (from 02.01.19)
Rapid access to specialist opinion for patients at home suffering an acute exacerbation of COPD preventing avoidable hospital admissions.
It is expected that referrals to this service will be from the patient’s GP and that patients will have been reviewed by their GP during this exacerbation to confirm the diagnosis.
Referrals:
Exacerbation telephone number 07876102460 : GP to discuss with the COPD team.
Outcome:
The Community COPD service will assess patients (in clinic or at home) and will provide either;
- Management plan and transfer patient care back to referring GP
- Management plan and share care with the patient’s GP until the patient is stable
- Admit patient to hospital for further assessment if required
Please note: restricted to individuals with an established diagnosis of COPD (i.e. not first presentation) with an acute exacerbation.
Exclusions:
Chest pain, Pneumonia, Pulmonary Embolus, Cardiac Failure etc.
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