A novel COPD anticipatory care service (CACS) to optimize high-risk population and alleviate winter pressures.

<bold>Background:</bold> COPD exacerbations impact on the National Health Service in UK; NHS and health inequalities lead to poor access to healthcare resources and so poorly managed disease and frequent winter exacerbations. Addressing COPD targets for best quality care proactively earlier in the year may prevent exacerbations and allow a systematic approach in a less time pressured environment. <bold>Aims:</bold> To assess the potential of a summertime CACS in community and primary care settings within Central London in improving patient outcomes in those with severe COPD, by reducing exacerbations and emergency hospital attendances during the winter which are often due to respiratory infection. <bold>Methods:</bold> An intuitive checklist, completed in clinic (virtual or face to face with multidisciplinary discussion prior to review) can be carried out by all professionals involved in long term conditions. <bold>Results:</bold> All 739 patients on the COPD register were reviewed virtually, 444(60%) were vaccinated for COVID-19 and Influenza. 192 were reviewed by CACS in person, of whom 58, treatment was optimised, 8 referred to secondary care and 15 more pulmonary rehabilitation referrals made. <bold>Conclusions:</bold> We perceive that these outcomes will in turn influence secondary care workload as patients will primarily be diagnosed and managed in the community for their COPD more effectively hence ultimately reducing secondary care attendance. Referrals to secondary care will also be of a higher quality. We hope this can be carried out at scale in the UK in the future and guide a more strategic and proactive approach to COPD management.