Matthew is a 72-year-old retired policeman with a complex medical history, including type 2 diabetes, a myocardial infarction eight years ago and moderate/severe COPD diagnosed three years ago.
He is an former smoker, having stopped when he was diagnosed with COPD, but he has a significant pack-year history of 60 years. He was due for a review of his COPD but telephoned the practice to cancel his appointment saying he had a chest infection, which was making him feel unwell.
The receptionist advised him to attend so that he could be assessed. He was seen by the advanced nurse practitioner (ANP) who recognised that his symptoms may have indicated that he was having an exacerbation of his COPD.