Room to breathe: a longitudinal review of respiratory data is a state of the nation review of care for people with asthma and COPD in hospital, and for people with COPD accessing pulmonary rehabilitation, between 2024-2025 in England and Wales. The report is compiled using data from services in England and Wales that participated in NRAP.
The National Respiratory Audit Programme’s latest State of the Nation report, Room to breathe: a longitudinal review of respiratory data, provides a comprehensive assessment of care for people with asthma and chronic obstructive pulmonary disease (COPD) across England and Wales. Drawing on data from hospital admissions and pulmonary rehabilitation services between April 2024 and March 2025, the report highlights persistent gaps in the delivery of key interventions known to improve patient outcomes.
A key finding is the wide variation in care between organisations and regions, demonstrating that high‑quality care is achievable but not consistently delivered. This variation signals opportunities for health systems to learn from higher‑performing services and to address unmet need through targeted improvement.
Overall, the report calls for coordinated national and local action to ensure that all patients receive timely, evidence‑based care, reduce unwarranted variation, and support sustainable service development. Strengthening participation in audit, embedding key interventions as standard practice, and investing in service capacity will be essential to improving outcomes for people living with respiratory disease.
