Adoption & Spread

The Adoption & Spread Safety Improvement Programme (A&S SIP) aims to identify and support the spread and adoption of effective and safe, evidence-based interventions and practice across England.


  • Increase the proportion of eligible patients receiving all elements of the chronic obstructive pulmonary disease (COPD) discharge care bundle to 80% by March 2022, and the asthma discharge care bundle to 80% by March 2023.
  • Increase the proportion of eligible sites adopting three evidence-based tracheostomy safety interventions (bedhead signs, availability of emergency equipment, daily care bundle) to 90% by March 2021.
  • Increase the proportion of patients receiving all elements for which they are eligible of the emergency laparotomy care bundle to 90% by October 2022.

The programme also works with national, regional and local partners to develop a “pipeline” of future improvements.


COPD is the second most common lung disease in the UK with an estimated 1.2 million people living with the condition.

Asthma affects 5.4 million people in the UK, and in 2016/17 77,124 people were admitted to hospital for asthma and the most recent data (2017) shows that 1,484 people died from an asthma attack in the UK. Specific recommendations are made in the British Thoracic Society/SIGN guidelines for the use of a discharge bundle including follow up arrangements as a key opportunity to secure good medical care post discharge.

The South West AHSN Adoption and Spread COPD and asthma work builds on the community of practice that was created prior to the onset of COVID-19.  We are working with COPD and asthma teams across the region to:

  • Use data from the National Asthma and COPD Audit Programme (NACAP) which demonstrates the adherence to the components of the COPD and asthma discharge care bundles, to support targeted quality improvement
  • Offer bespoke support and assistance, enabling teams to create localised improvement plans to improve the implementation of all components of the COPD and asthma discharge care bundles
  • Provide a regional support network to enable shared learning between teams across the region.

This respiratory project links to our Rapid Uptake Product programme to improve appropriate referral for fractional exhaled nitric oxide (FeNO) testing for asthma diagnosis.

We are also working with the South West Respiratory Clinical Network to improve respiratory care for people in the South West.


The number of patients requiring relatively prolonged ventilatory support in intensive care due to coronavirus (COVID-19) led to increased numbers of patients requiring tracheostomies, which are used to help wean some patients from respiratory support.

The AHSN Network published, in collaboration with the National Tracheostomy Safety Project and the National Patient Safety Improvement Programmes, a toolkit for healthcare staff to support them to safely care for patients with tracheostomies.

For more information take a look at this AHSN Network impact case study on tracheostomy care.


From December 2018 to November 2019, 24,823 patients had emergency laparotomies in England and Wales. For more information please visit the AHSN Network website.

Previous work undertaken by the National Patient Safety Improvement Programme and the AHSN network focussed on adopting one or more element of an emergency laparotomy care bundle. The NatPatSIP team are currently reviewing the adoption of the emergency laparotomy care bundle within acute NHS trusts in England and scoping opportunities for further improvement work. The South West AHSN has recently engaged with local trusts in Somerset, Devon and Cornwall to understand their current position to feed into this national review.