Respiratory health

What are the unmet needs/ service gaps?

Chronic Obstructive Pulmonary Disease (COPD)

The gaps below have been identified.  The COPD service was re-commissioned in a new model of care on 1 February 2012 taking into account the needs of the population.  The service gaps addressed were:

  • A model estimates that the number of COPD patients in Central Bedfordshire was 4,860 and that may mean 1,170 people were undiagnosed
  • There is no expert patient programme.  The patient education and rescue medication prescribing are variable
  • There is no specialist service for the admission avoidance scheme for exacerbations
  • Patients have to be referred before 2pm by ARAS to be seen on the same day.  It is particularly out of hours that there is a requirement for a service


  • Although there is a specialist allergy service at Bedford Hospital, there is a lack of allergy advice at Luton and Dunstable Hospital (L&D)
  • Prescribers are often confused about where a particular product fits within the guidelines, which products to use or whether to start a patient when they are experiencing an exacerbation of symptoms.  Quite often patients are stepped up but then not regularly reviewed and stepped down the treatment pathway
  • There is underutilisation of community pharmacy providing patients with asthma prescribed inhalers a New Medicine Service (NMS) or Medicines Use Review (MUR).  They are both free to use that aims to help patients get the most out of their medicines
  • There is a potential for misdiagnosis between asthma and Chronic Obstructive Pulmonary Disease.  This is a national issue

Last updated Friday, 22nd April 2016