A multicentre randomised clinical trial of 1400 patients will be conducted in 30 acute NHS trusts. This will test the hypothesis that a self-supported rescue pack management plan consisting of rescue packs + written self-management plan + twice weekly telephone/text symptom alert assessments in the high-risk 90-day period is better than standard care in reducing 90-day readmission by 20%. If successful, this intervention would be rapidly implementable, improve patient clinical outcomes and have a cost saving of approximately £350 million per annum. conditions: COPD conditions: COPD Exacerbation studyType: INTERVENTIONAL phases: PHASE3 allocation: RANDOMIZED interventionModel: PARALLEL primaryPurpose: TREATMENT masking: NONE count: 1400 type: ESTIMATED name: Supported rescue pack measure: Time to first all-cause readmission within 90 days of discharge measure: Time to and frequency of COPD-related readmissions at 30 and 90 days measure: Days alive and out of hospital at day 90 measure: Time to and frequency of all COPD exacerbations at days 30 and 90 measure: Cumulative systemic oral corticosteroids use over 90 days measure: Cumulative systemic antibiotic use over 90 days measure: Health care contacts at baseline, days 90 and 180, and 1 year measure: All cause readmission at 30 days measure: All cause-, cardiovascular- and COPD- related mortality at day 90 and over 12 months measure: EQ-5D-5L Health questionnaire (quality of life) at days 90 and 180, and 1 year measure: Incremental cost-effectiveness ratio (ICER, a ratio of the additional cost divided by the additional effectiveness of SRP compared to UC) at days 90 and 180 and 1 year measure: Qualitative interviews to examine and describe usual care measure: Qualitative interview examination of fidelity to and adaptation of the plan in the intervention arm measure: Serious adverse events measure: Antimicrobial resistance measure: Quality of life COPD assessment Test (CAT) score at days 90, 180 and 1 year sex: ALL minimumAge: 40 Years stdAges: ADULT stdAges: OLDER_ADULT facility: University Hospitals Birminham NHS Foundation Trust city: Birmingham country: United Kingdom lat: 52.48142 lon: -1.89983 facility: Blackpool Teaching Hospitals city: Blackpool country: United Kingdom lat: 53.81667 lon: -3.05 facility: Bradford Teaching Hospitals NHS Foundation Trust city: Bradford country: United Kingdom lat: 53.79391 lon: -1.75206 facility: University Hospitals Sussex NHS Foundation Trust city: Brighton country: United Kingdom lat: 50.82838 lon: -0.13947 facility: North Bristol University Trust city: Bristol country: United Kingdom lat: 51.45523 lon: -2.59665 facility: County Durham and Darlington NHS Foundation Trust city: Durham country: United Kingdom lat: 54.77676 lon: -1.57566 facility: East Suffolk and North Essex Foundation Trust city: Ipswich country: United Kingdom lat: 52.05917 lon: 1.15545 facility: University Hospitals of Morecambe Bay NHS Foundation Trust city: Lancaster country: United Kingdom lat: 54.04649 lon: -2.79988 facility: University Hospitals of Leicester NHS Trust city: Leicester country: United Kingdom lat: 52.6386 lon: -1.13169 facility: Cardiff and Vale University Health Board city: Llandough country: United Kingdom lat: 51.44556 lon: -3.44722 facility: Guy's and St Thomas' NHS Foundation Trust city: London country: United Kingdom name: Mona Bafadhel, Professor role: PRINCIPAL_INVESTIGATOR lat: 51.50853 lon: -0.12574 facility: Imperial College Healthcare NHS Trust city: London country: United Kingdom lat: 51.50853 lon: -0.12574 facility: Royal Free London NHS Foundation Trust city: London country: United Kingdom name: John Hurst, Professor role: PRINCIPAL_INVESTIGATOR lat: 51.50853 lon: -0.12574 facility: Maidstone and Tunbridge Wells NHS Trust city: Maidstone country: United Kingdom lat: 51.26667 lon: 0.51667 facility: South Tees NHS Foundation Trust city: Middlesbrough country: United Kingdom lat: 54.57623 lon: -1.23483 facility: Milton Keynes University Hospital NHS Foundation Trust city: Milton Keynes country: United Kingdom lat: 52.04172 lon: -0.75583 facility: Newcastle Upon Tyne Hospitals NHS Foundation Trust city: Newcastle Upon Tyne country: United Kingdom lat: 54.97328 lon: -1.61396 facility: Northumbria Healthcare NHS Foundation Trust city: North Shields country: United Kingdom lat: 55.01646 lon: -1.44925 facility: Nottingham University Hospitals Trust city: Nottingham country: United Kingdom lat: 52.9536 lon: -1.15047 facility: Oxford University Hospitals NHS Foundation Trust city: Oxford country: United Kingdom lat: 51.75222 lon: -1.25596 facility: Salisbury NHS Foundation Trust city: Salisbury country: United Kingdom lat: 51.06931 lon: -1.79569 facility: University Hospital Southampton NHS Foundation Trust city: Shirley country: United Kingdom lat: 52.41074 lon: -1.81952 facility: Frimley Health NHS Foundation Trust city: Slough country: United Kingdom lat: 51.50949 lon: -0.59541 facility: South Tyneside and Sunderland NHS Trust city: South Shields country: United Kingdom lat: 54.99859 lon: -1.4323 facility: Stockport NHS Foundation Trust city: Stockport country: United Kingdom lat: 53.40979 lon: -2.15761 facility: North Tees and Hartlepool NHS Foundation Trust city: Stockton-on-Tees country: United Kingdom lat: 54.56848 lon: -1.3187 facility: Sherwood Forest Hospitals NHS Foundation Trust city: Sutton In Ashfield country: United Kingdom lat: 53.12542 lon: -1.26135 facility: Somerset Foundation Trust city: Taunton country: United Kingdom lat: 51.01494 lon: -3.10293 facility: Somerset Foundation Trust city: Yeovil country: United Kingdom lat: 50.94159 lon: -2.63211 hasResults: False