Severe COPD Shielding Identifying At Risk patients Without Spirometry

Hi All,

As a general practice we are currently looking at our COPD population and considering who has not already had a 'High Risk Letter' but may need one from ourselves. Severe COPD would automatically include those with spirometry to indicate obstruction with FEV1 less than 50% predicted but we were concerned about other patients with better spirometry but severe symptoms/frequent exacerbations. Is anyone running any SystmOne searches for these people and if so what codes are you using to identify them please?

Best wishes,


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  • Hi Nicola ,

    I have been checking some of our resp patients notes re. shielding as was concerned that some high risk had been downgraded to moderate as the GPs had been asked to reduce our numbers in the high risk group !

    I found occasional people with FEV1 below 30% that were not picked up by national searches & also people who could be termed severe COPD depending which guideline was used so have moved many back to high risk. Be mindful of those with comorbidities eg. CVD & diabetes as the combination of those alongside respiratory problems increases overall risk . Main message would be follow gut instincts & if possible individualised risk assessment .


    It's a can of worms & very time consuming!

    All the best


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