COPD is the sixth most common cause of death in England and Wales killing more than 30,000 a year; and morbidity is high with people needing frequent primary and secondary care input. The population prevalence of COPD is expected to increase over time due to ageing of the population, and the cumulative effect of smoking.
The health of the people of the East Midlands is very similar to that of the country as a whole, but within the East Midlands there is considerable inequality of health between localities and population groups. Currently, 1.6% of the population in NHS East Midlands have a recorded diagnosis of COPD which equates to 73,400 people and is forecast to rise 142,095 by 2020 because of improved detection and diagnosis. Prevalence varies between 0.3% and 2.5% across the constituent practices. As with the National picture, there are marginally more men diagnosed than women, and higher diagnosis rates in areas of higher socio economic deprivation.
The financial impact on the NHS is significant; In 2008/9 there were 14,506 un-planned admissions for COPD which cost in the region of £34m and necessitated 67,500 emergency day beds across the region. Over £60m is spent on prescribing, not including oxygen, which is around £8m per annum, for respiratory conditions as a whole across the region every year, and a sizeable proportion of this is for people with COPD.
The impact on people’s lives in the East Midlands, both patients and carers is sizeable, and the issue of greatest concern is the variation between each cluster and between practices within those clusters. Recent analysis of our East Midlands COPD data, has shown considerable differences in terms of expenditure on services, and associated outcomes for patients that cannot be explained solely by differences in population demographics (East Midlands COPD dashboard).