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Abstract
This British Thoracic Society Quality Standard for Clinically Significant Bronchiectasis in Adults 2022 aims to encourage good practice by setting standards of high-quality respiratory care that services should follow.
- Bronchiectasis
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The British Thoracic Society (BTS) has been at the forefront of the production of guidelines for best clinical practice in respiratory medicine, since the society was established 40 years ago. The society was awarded National Institute for Health and Care Excellence (NICE) accreditation for its guideline production process in November 2011 and the society’s Guideline Production Manual setting out the detailed methodology and policy to produce guidelines is reviewed annually by the BTS Standards of Care Committee (SOCC).
A statement on quality standards based on each BTS guideline is a key part of the range of supporting materials that the society produces to assist in the dissemination and implementation of a guideline’s recommendations.
A quality standard is a set of specific, concise statements that:
Act as markers of high-quality, cost-effective patient care across a pathway or clinical area, covering treatment or prevention.
Are derived from the best available evidence.
NICE Quality Standards and the 2021 NICE Quality Standards Process Guide1 were used as a model for the development of BTS Quality Standards.
This document contains Quality Standards to be used in primary and secondary care for clinically significant bronchiectasis in adults (patients with the clinical syndrome of regular cough and sputum production, with or without recurrent chest infections and radiological confirmation of bronchiectasis). This document supersedes the BTS Quality Standards for Clinically Significant Bronchiectasis in Adults, published in 2012.2
The rationale for these quality standards is drawn from evidence and recommendations summarised in the BTS Guideline for Bronchiectasis in Adults 2019.3 A link to that document can be found below: https://www.brit-thoracic.org.uk/document-library/guidelines/bronchiectasis/bts-guideline-for-bronchiectasis-in-adults/.
This document aims to improve the standards of care for people with bronchiectasis. The purpose of the document is to provide commissioners, planners and patients with a guide to the minimum standards of care that patients with this particular disease should expect, together with measurable markers of good practice.
BTS Quality Standards are intended for:
Healthcare professionals to allow decisions to be made about care based on the latest evidence and best practice.
Patients with bronchiectasis and their carers to enable understanding of what services they should expect from their health and social care provider.
Service providers to be able to quickly and easily examine the clinical performance of their organisation and assess the standards of care they provide.
Commissioners so that they can be confident that the services they are purchasing are high quality and cost-effective.
Method of working
The BTS convened a Bronchiectasis Quality Standard Working Group in March 2021, with the following membership:
Name, role and location
Adam T Hill, chair—consultant respiratory physician, Edinburgh.
Lizzie Grillo—advanced physiotherapist, London.
Kevin Gruffydd-Jones—general practitioner, Wiltshire.
Michael Loebinger—consultant respiratory physician, London.
Karen Payne—adult bronchiectasis nurse specialist, Leicester.
Miguel Souto—head of clinical programmes, BTS.
Anita Sullivan—consultant respiratory physician, Birmingham.
James Wildgoose—patient representative.
We would also like to acknowledge the contributions of the following, who were members of the group that developed the original Quality Standard in 2012: Diana Bilton, Jerry Brown, Graham Burns, James Calvert, Karen Heslop, Wei Shen Lim, Joan Manzie, Mark Pasteur, Frances Sinfield, John White and Sally Welham.
Members of the Quality Standard Working Group submitted declaration of interest forms in line with the BTS Policy and copies of the forms are available on request from BTS head office.
The draft document was considered in detail by the BTS SOCC at its meeting in September 2021.
The document was made available on the BTS website for public consultation for the period from 16 May 2022 to 20 June 2022.
Following further revision, the document was submitted for approval to the BTS SOCC on 1 July 2022
The quality standard document will be reviewed in July 2025 or following the publication of a revised Guideline whichever is the sooner.
Each quality standard includes the following:
A quality statement, which describes a key marker of high-quality, cost-effective care for this condition.
Quality measures, which aim to improve the structure, process and outcomes of healthcare.
The quality measures are not intended to be new sets of targets or mandatory indicators for performance management that need to be collected. The quality measures are specified in the form of a numerator and a denominator, which define a proportion or ratio (numerator/denominator). It is assumed that the numerator is a subset of the denominator population. The suggested numerator and denominator are provided to allow healthcare professionals and service providers to examine their clinical performance in relation to each quality standard. It is recognised that no national quality indicators will be available for this condition, and institutions will need to agree locally what information is required for the denominator to be used in each case, and what the expected level of achievement should be, given local circumstances. A brief description about the quality standard in relation to each audience is given.
The BTS Guideline for Bronchiectasis in Adults 20193 is the main reference for all six quality statements. There is no specific order of priority associated with the list of quality statements.
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Footnotes
Contributors All authors contributed equally to the development of the statement.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.
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