Large scale change is difficult to bring about. The regional Respiratory Programme began in 2011 with the aim of improving outcomes in COPD and asthma. We designed a COPD dashboard with key metrics aiming to track progress and encourage involvement in service improvement. The Quality Observatory maintain the dashboard and release quarterly updates which we email out to our network members and other key people (n = 396) accompanied by commentary indicating issues for consideration and highlighting trends. The target audience includes clinicians in primary, secondary and community care plus managers and commissioners. This work is supplemented by running oxygen and pulmonary rehabilitation clinical networks which provide support and training to clinicians plus a quarterly educational and information sharing epublication ‘Breathing Matters’. We track trends in metrics. COPD bed days are a key outcome measure and the table below shows the yearly value since the program commenced.

Looking at the admission figures on a population basis i.e. admissions per 1,000 COPD population (population weighted for prevalence of COPD using ERPHO modelled estimates and projections) there is a similar trend:

County 1 2010/11 17.9 per 1000 vs 13.2 per 1000 in 2013/14

County 2 2010/11: 12.5 per 1000 vs 10.3 per 1000 in 2013/14

County 3 2010/11: 15.8 per 1000 vs 13.8 per 1000 2013/14

There has been a reduction in variation between acute trusts in the number of admissions and length of stay (without an increase in re-admission rate). We believe our COPD Dashboard has helped drive this change.