• chronic obstructive pulmonary disease
• NICE guidelines

The full version of the new NICE guidelines on the management of chronic obstructive pulmonary disease (COPD) is published as a supplement to this issue of Thorax.¹ These guidelines have been developed for the National Institute for Clinical Excellence (NICE) by the National Collaborating Centre for Chronic Conditions (NCC-CC) based at the Royal College of Physicians, London with the involvement of many members of the British Thoracic Society (BTS). The Guideline Development Group and Consensus Reference Group involved in the production of the guidelines included members with diverse professional backgrounds and, crucially, also included patient representatives. The scope of the guidelines is wide. They address the diagnosis and assessment of people with COPD as well as the pharmacological and non-pharmacological management of stable disease and exacerbations.

With the recent update to the GOLD guidelines² and the forthcoming publication of joint guidelines by the American Thoracic Society (ATS) and the European Respiratory Society (ERS), the need for new British guidelines could be questioned. I have no doubt that there is a role for these guidelines as they address issues such as pulmonary rehabilitation from a British perspective and, most importantly, are truly evidence-based. Moreover, in the absence of a National Service Framework for respiratory medicine, and the reality that such a framework is unlikely to be introduced in the near future, these NICE guidelines offer the best hope of raising the standards of care of this common disabling chronic disease.

The key issues for practising clinicians are:

• What is new in these guidelines?

• How do they relate to other international guidelines?

Significant changes in practice have evolved since the BTS guidelines on the management of COPD were published in 1997, …