Case Study:

NACAP Quality Improvement Programmes

The Official Delivery Partners of the NACAP QI Projects


To address long-standing issues in national audit data, including misdiagnosis, Pulmonary Rehabilitation referrals, and Asthma deaths, ICST partnered with the Royal College of Physicians (RCP) and the NACAP audit team.

Together, we developed and implemented quality improvement practices to improve these outcomes. This initiative was integrated into the Respiratory Toolkit, already deployed nationwide in Wales.


Respiratory Toolkit

Through a collaboration involving the RCP, NACAP, ICST, and NHS Wales, a solution was created to bridge policy and patient care. ICST created six peer-reviewed quality improvement (QI) projects targeting COPD and asthma patient diagnosis and care, optimising value for patients.

Using implementation science and behavioural methodologies, the programme achieved widespread adoption without needing additional resources, enabling seamless integration into existing systems. By prioritising practical support over drastic change, the toolkit minimises resistance and ensures sustainability and broad-scale impact.

Continuous monitoring of uptake and engagement, alongside audience feedback, is guiding ongoing development, ensuring the QI projects remain tailored to the needs of healthcare professionals and patients, and adapting to changing priorities.

Learn More About:

Respiratory Toolkit

A strategy to improve the standards of respiratory care across a health system, ensuring that all patients receive high-value care, and all healthcare professionals understand how to optimise the care for their patients.


Respiratory Toolkit

Near-perfect coverage

Where the NACAP programme has been implemented, including on a National basis, we see coverage of 98% of GP practices that have healthcare professionals using the toolkit.

Removing barriers

QI projects were supported by recourses to make the QI project as easy as possible for busy healthcare professionals, These resources are part of the programme, freely accessible to all users.

Changing audit data

Data from the latest NACAP audit demonstrates improvements in care, such as increased pulmonary rehabilitation rates. These improvements serve as a testament to the effective partnership between RCP, ICST, NACAP, and NHS Wales.

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