From Department of Health
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Today, the Minister for Health, Stephen Donnelly, welcomes the publication of a new National Clinical Effectiveness Guideline to help healthcare professionals manage Chronic Obstructive Pulmonary Disease (COPD).
This new guideline was developed by a multidisciplinary Guideline Development Group supported by the HSE National Clinical Programme for Respiratory. The guideline development group was chaired since 2020 by Dr Desmond Murphy, and previously by Professor Tim McDonnell.
Chronic Obstructive Pulmonary Disease (COPD) is the most prevalent respiratory disease in adults and is a major cause of morbidity and mortality. At least 1,500 patients die each year of this disease and over 15,000 patients are admitted to hospital with COPD in Ireland.
COPD has considerable impact on the quality of life of the patient, families, and carers, involving ongoing medical care, frequent hospital admissions for treatment of exacerbations and often resulting in premature death.
The development of this national clinical guideline for COPD is a major step forward in that it will ensure that COPD patients across the country receive consistent and standardised care, based on the best available evidence.
NCEC National Clinical Guideline No. 27 was quality assured by the department’s National Clinical Effectiveness Committee (NCEC). This guideline has received Ministerial endorsement as a high-quality guideline to be implemented across the health service.
Supporting the publication today, Minister Donnelly said:
“I am pleased to endorse this National Clinical Guideline in relation to the Management of Chronic Obstructive Pulmonary Disease (COPD) which will be implemented across the health service to help support safe, high-quality care for patients.
“COPD is the most prevalent respiratory disease in adults and has a huge impact on people’s quality of life and that of their family. This guideline outlines the best practice care and services for people with COPD or at risk of developing COPD. This guideline will help healthcare workers provide care based on the best available evidence.”
The Minister continued:
“The guideline development has been informed by a full public consultation and reviewed by international experts and I acknowledge the work of all involved to make these guidelines available for patient care. I see the publication of this guideline as a further advance in improving the standard and consistency of care of patients with COPD across the country.”
Dr Desmond Murphy, Chair of the Guideline Development Group and Clinical Lead, HSE National Clinical Programme, Respiratory, commented:
“The NCEC document for COPD represents the culmination of a lot of work, by a lot of people to develop a framework to support the provision of optimal care for COPD patients in Ireland. The document has been reviewed by multiple different elements within the Irish healthcare provider system and also by patient advocacy groups, with feedback incorporated. Furthermore, it has been reviewed by recognised international experts in COPD. It is a pleasure to see the document launched. I believe this represents significant progress for patients with COPD in Ireland."
Dr Tony Holohan, Chief Medical Officer said:
“I greatly welcome this latest National Clinical Guideline, which was developed by a multi-disciplinary Guideline Development Group, led by Dr Desmond Murphy and supported by the HSE National Respiratory Programme. Making the evidence available in an accessible way to healthcare professionals is critical in enabling evidence-based practice and safe, high quality patient care.
“The guideline has been quality assured by the National Clinical Effectiveness Committee in line with international best practice and has undergone public consultation and international expert review. I would like to acknowledge the work of all involved to make these guidelines available for patient care to further improve the management of COPD in Ireland."
Ms Rachel Kenna, Chief Nursing Officer acknowledged:
“The development of the NCEC National Clinical Guideline on the Management of COPD is an important support to progress patient care for those affected by COPD in Ireland. This is important as we seek to progress health service reforms and innovative approaches such as the work done on the Community Virtual Ward (CVW) initiative. This model of care delivers an integrated approach to care of patients with chronic diseases such as COPD leading to improved patient outcomes.”
The Minister for Health, Stephen Donnelly congratulated the Guideline Chair, the Guideline Development Group and all who worked to bring this guideline to final publication today so that the guideline is available for healthcare professionals to use in patient care.
The National Clinical Effectiveness Committee (NCEC) provides leadership for clinical effectiveness through prioritisation and quality assurance of National Clinical Guidelines and National Clinical Audit. Twenty-six NCEC National Clinical Guidelines on a range of conditions and healthcare processes have already been published. Extending and implementing the suite of NCEC guidelines remains a priority of national health policy.
Clinical effectiveness is a key component of patient safety. The integration of best evidence in service provision, through clinical effectiveness processes, promotes healthcare that is up to date, effective and consistent. Clinical effectiveness processes include guidelines, audit and practice guidance.
NCEC Terms of Reference:
1. Provide strategic leadership for the national clinical effectiveness agenda.
2. Contribute to national patient safety and quality improvement agendas.
3. Publish standards for clinical practice guidance.
4. Publish guidance for National Clinical Guidelines and National Clinical Audit.
5. Prioritise and quality assure National Clinical Guidelines and National Clinical Audit.
6. Commission National Clinical Guidelines and National Clinical Audit.
7. Align National Clinical Guidelines and National Clinical Audit with implementation levers.
8. Report periodically on the implementation and impact of National Clinical Guidelines
and the performance of National Clinical Audit.
9. Establish sub-committees for NCEC work-streams.
10. Publish an Annual Report.
Further information about the NCEC and National Clinical Guidelines is available: https://www.gov.ie/en/publication/90221b-clinical-effectiveness/
Chronic Obstructive Pulmonary Disease has considerable impact on the quality of life of the patient, families, and carers, involving on-going medical care, frequent hospital admissions for treatment of exacerbations and often resulting in premature death. At least 1,500 patients die each year of this disease and over 15,000 patients are admitted to hospital with COPD in Ireland.
It is estimated that 380,000 people are living with COPD yet only 110,000 are diagnosed.
An ageing Irish population together with current and historical smoking prevalence means that the health burden of COPD in Ireland will continue to increase and be a significant burden to people, health services and society for the foreseeable future.
While we continue to see improvements in hospitalisation rates for COPD, in international terms the rate for COPD in Ireland indicates that improvements remain to be made in this area.
This development of this national clinical guideline for COPD is a major step forward in that it will ensure that COPD patients across the country receive consistent and standardised care, based on the best available evidence.
Proof of concept (POC) testing of an integrated nurse-led community virtual ward (CVW) has taken place. This innovative approach to care provides greater access and choice to support people to self-manage and live independently and facilitates integration of services at greater value for money. A Community Virtual Ward (CVW) benefits patients in areas such as chronic disease management and older persons care and supports a shift in care from the acute hospital to the community. The CVW
is a flexible and integrated model working across community and hospital settings, receiving admissions from both areas.
It is termed a CVW as the care is delivered in the community in the person’s home and beds are not physical beds but virtual beds. The CVW operates similarly to a ward in that a team of nurses provide care for the duration of the admission.
The CVW was tested as part of the Implementation Plan for the EN role to facilitate a shift in practice to the community and support ENs to work at the top of their licence. The CVW was tested as a proof of concept to examine design and functionality of the model before entering any larger-scale pilot testing.
Further information on the testing and results of an integrated nurse-led community virtual ward proof-of-concept is available: The Testing and Results of an Integrated Nurse-led Community Virtual Ward Proof-of-Concept