Catching our breath: Time for change in respiratory care (NRAP)

Reports | Published: 12 Jun 2025

The National Respiratory Audit Programme (NRAP) has released Catching Our Breath, a report offering important insights into the current state of respiratory care across England and Wales.

Integrated care boards and local health boards should regularly review NRAP data on discharge planning for CYP and adult asthma and COPD with their providers

Based on admissions from April 2023 to March 2024, this report identifies continued and highly significant deficiencies in the delivery of many of the key interventions for patients with asthma and COPD that are known to improve health and outcomes. It also highlights regional variability, providing a clear signal for health systems to follow, not only to address existing unmet needs but to support service development and strategies for ongoing healthcare improvement at a local and regional level.

Despite this picture, there are reasons for optimism. 2024 saw the launch of the NRAP Healthcare Improvement Programme, showing both the appetite and ability to drive change.

Recommendations for improvement include:

  • Integrated care boards and local health boards should mandate all eligible services to participate in NRAP to achieve 100% service participation and a minimum of 50% case ascertainment by all services in NRAP audits
  • The British Thoracic Society should lead the development of a standardised acute care bundle for patients with asthma and COPD on arrival to hospital
  • All people with COPD and asthma who smoke, and smokers who are parents of children and young people with asthma, should be offered evidence-based treatment and referral for tobacco dependency.

Read the full report: You can view the report by clicking the button below.

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Catching our breath: Time for change in respiratory care (NRAP)