Table 1

 Recommendations from the NICE guidelines

Hospital-at-Home and assisted discharge schemes are safe and effective and should be used as an alternative way of managing patients with exacerbations of COPD who would otherwise need to be admitted or stay in hospital.Grade A
The multi-professional team required to operate these schemes should include allied health professionals with experience in managing patients with COPD, and may include nurses, physiotherapists, occupational therapists and generic health workers.Grade D
There are currently insufficient data to make firm recommendations about which patients with an exacerbation are most suitable for Hospital-at-Home or early discharge. Patient selection should depend on the resources available and absence of factors associated with a worse prognosis,eg acidosis.Grade D
Patients’ preferences about treatment at home or in hospital should be considered.Grade D