The challenge

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause severe breathing difficulties. It includes:

  • emphysema – damage to the air sacs in the lungs
  • chronic bronchitis – long-term inflammation of the airways

COPD is a common condition that mainly affects middle-aged or older adult. COPD happens when the lungs become inflamed, damaged and narrowed. The main cause is smoking, although the condition can sometimes affect people who have never smoked.

Those who do have it can find their normal activities severely limited, with the main symptoms being:

  • increasing breathlessness, particularly when people are active
  • a persistent chesty cough with phlegm – some people may dismiss this as just a “smoker’s cough”
  • frequent chest infections
  • persistent wheezing

However, timely treatment can help to keep the condition under control.  This can include short-acting bronchodilator inhalers, amongst other treatments.

The outlook for COPD varies from person to person. The condition cannot be cured or reversed, but for many people, treatment can help keep it under control so it does not severely limit their daily activities.


Case study – Norfolk Care

what is the COPD service?

Increase clinic capacity and improve clinical outcomes with COPD home monitoring

The COPD service closely monitors patients with the condition in the comfort of their own homes.

This helps to increase clinic capacity, as those with mild symptoms may not need to attend outpatients’ clinics at hospitals.

Clinical outcomes are also improved, as patients receive ongoing home monitoring, as opposed to simply being monitored when they attend potentially infrequent hospital appointments.

The service monitors patients closely in the comfort of their own home and highlights deterioration in health, resulting in early intervention.

What does the COPD service do?

The COPD service assists patients by monitors patients’ oxygen levels and alerts clinical team based on specific algorithms.  The service monitors patients closely in the comfort of their own home and highlights deterioration in health, resulting in early intervention.

Patients are provided with devices to monitor their Sp02 levels, C02 levels, heart rate, temperature, blood pressure and weight. Patients relay readings via a communication channel of their choice (e.g. an automated telephone call, SMS, app or online). Readings integrate into the patient record.

If readings fall out of range, a healthcare professional is alerted to take appropriate action. All readings can be viewed in the patient record for authorised professionals to view.

The service means patients no longer have to attend routine GP appointments.


Norfolk Community Health and Care Trust have implemented a new remote-monitoring service for people with heart and lung disease.   The trust has reported a reduction in A&E admissions and bed days among a group of high-dependency patients following the introduction of the service.

51 patients are currently being monitored on the service.

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Case study – Norfolk Care