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Urgent health guide

By Does Your Duck Quack

COPD and heart-failure action plans

COPD and heart failure action plans: recognise changes, follow clinician-agreed steps and know when worsening symptoms need urgent help.

Checked: 12 October 2026 · Next review: 12 April 2027 · Applies to: UK, with nation notes
How this guide was prepared

Purpose: urgent guidance · Level: detailed

Checked by: Does Your Duck Quack. Sources are linked below; seek professional advice for individual circumstances.

The short answer

What to do first

COPD and heart failure action plans: recognise changes, follow clinician-agreed steps and know when worsening symptoms need urgent help.

Start here: Ask the GP, respiratory nurse or heart-failure team for a plan the person can use. If both conditions are present, separate COPD and heart-failure instructions clearly. Include usual symptoms, named contacts, urgent signs and review arrangements. Ask for plain language and involve supporters only with consent.

Do not wait: Call 999 for severe breathlessness, chest pain, blue lips, collapse, or new confusion with a sudden serious deterioration. If symptoms are worsening but not immediately life-threatening, follow the action plan and contact the named nurse, GP or urgent NHS service the same day.

Visual guides

See the decision at a glance

Make a written action plan
  1. 1. Ask the clinical teamRequest a plan that separates COPD and heart-failure instructions where both apply.
  2. 2. Record usual symptomsNote the person’s baseline and changes they should report.
  3. 3. Set out contactsWrite down the named nurse, GP and urgent route, including out-of-hours advice.
  4. 4. Share and reviewKeep it accessible and share with chosen helpers with the person’s consent.
COPD or heart-failure changes?
  1. COPD may worsenNotice increased breathlessness, cough, sputum or difficulty with usual tasks.
  2. Heart failure may worsenNotice breathlessness, swollen legs, difficulty lying flat or unusual tiredness.
  3. Severe symptomsCall 999 for severe breathlessness, chest pain, blue lips, collapse or sudden confusion.
  4. Rescue medicinesUse a prescribed rescue pack only according to the person’s written instructions.

Scope of this guide

This guide helps you understand the options and questions to ask. It is not personal medical, legal or financial advice. Check the official sources for your nation and seek qualified help for high-stakes decisions.

If someone may be in immediate danger

Call 999 for a life-threatening emergency. For an urgent problem that is not clearly life-threatening, use the official NHS urgent-care route for the UK nation you are in. Have the address, symptoms, onset time, medicines and allergies ready.

Who this guide is for

People living with COPD, heart failure or both, and supporters who want clear, condition-specific steps when symptoms change.

A written action plan records what is usual, which changes matter and who to contact. COPD and heart failure can both cause breathlessness, but they need different responses. A clinician must agree the instructions; a checklist cannot replace an individual assessment.

What to do now

1. Ask for a written plan

Ask the GP, respiratory nurse or heart-failure team for a plan the person can use. If both conditions are present, separate COPD and heart-failure instructions clearly. Include usual symptoms, named contacts, urgent signs and review arrangements. Ask for plain language and involve supporters only with consent.

2. Notice changes from usual

For COPD, watch for worse breathlessness, cough, sputum or ability to do usual tasks. For heart failure, increasing breathlessness, swollen legs, difficulty lying flat, unusual tiredness or weight change may signal deterioration. Monitor weight only if the clinician has asked and explained what to report. Record the change and when it began.

3. Use rescue medicine only as directed

Some people have a prescribed COPD rescue pack; it is not for everyone. Ask what symptoms mean starting it, how to take it and when to call. Do not use leftover antibiotics or steroids, change oxygen or alter water tablets without written instructions. If unsure whether the plan applies, call the named clinician or urgent NHS service.

4. Ask about rehabilitation and prevention

Ask whether pulmonary or cardiac rehabilitation is suitable and if community, home or remote support is available locally. Discuss current vaccination advice, inhaler technique, smoking support, fluids and activity pacing with the treating team. Advice should fit both conditions and the person’s preferences; avoid starting strenuous exercise during a flare without clinical guidance.

5. Share and review the plan

Keep the plan where the person and chosen helpers can find it, sharing it with consent. Include medicine details and contact routes without displaying private information to visitors. Ask for review after admission, repeated flare, medicine change or new difficulty following the plan. Call 999 for severe breathlessness, chest pain, blue lips, collapse or sudden confusion.

Warning signs and checks

Common questions

How do I get a COPD action plan?

Ask the GP, respiratory nurse or specialist team to write a plan with you. It should explain usual symptoms, important changes, any prescribed rescue treatment, who to call and when to seek emergency help. Request an accessible copy. If heart failure is also present, make sure the COPD and heart-failure instructions are clearly separated.

Does everyone with COPD need a rescue pack?

No. A clinician prescribes a rescue pack only when appropriate and explains exactly when to use it. Ask which symptoms apply and what follow-up is needed. Do not use leftover antibiotics or steroids. Worsening breathlessness can have causes other than COPD, including heart failure, so follow the person’s own escalation plan.

What symptoms suggest heart failure is getting worse?

Worsening breathlessness, leg swelling, difficulty lying flat, unusual fatigue or weight change can be warning signs. Follow the individual plan and measure weight only if the team has asked you to. Contact the heart-failure team or GP promptly. Call 999 for severe breathlessness, chest pain, blue lips, collapse or sudden confusion.

Are pulmonary and cardiac rehabilitation available at home?

Rehabilitation availability and suitability vary. Ask the respiratory or heart-failure team whether a referral is appropriate and whether home or community support is offered locally. A programme should fit the person’s health and plan. Do not start demanding exercise while symptoms are unstable without clinical advice.

Differences across the UK

Care and urgent routes differ between the NHS systems in England, Scotland, Wales and Northern Ireland. Respiratory and heart-failure teams, rehabilitation access and referrals vary locally. Ask the GP or specialist team to name the contact for the person’s location and the right out-of-hours route; do not assume another nation’s plan or phone number applies.

When to get urgent help

Call 999 for severe breathlessness, chest pain, blue lips, collapse, or new confusion with a sudden serious deterioration. If symptoms are worsening but not immediately life-threatening, follow the action plan and contact the named nurse, GP or urgent NHS service the same day.

Primary sources

The publisher checked this guide against the 6 official sources below. This is an editorial source check, not approval by a clinician, lawyer or benefits adviser.

Editorial note: By Does Your Duck Quack.