Quality statement 4: Information about community-acquired pneumonia
Quality statement
People with community-acquired pneumonia are given information on expected recovery timescales and when to seek further medical advice. [new 2025]
Rationale
Giving people with community-acquired pneumonia, and their family and carers if appropriate, advice and information on the expected timeframes for symptoms to improve, can help them to understand their recovery. Whilst there can be variation in the time taken for symptoms to resolve, for most otherwise healthy people, their symptoms will steadily improve after starting treatment. Some symptoms take longer to resolve than people may expect, particularly cough which can take several weeks to resolve. This can contribute to unnecessary repeat visits to the GP. Providing information on expected recovery times can reassure people that symptoms are resolving as would be expected.
People with community-acquired pneumonia, and their family and carers if appropriate, should also receive information that confirms when they should seek further medical advice.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Process
Proportion of people with community-acquired pneumonia who were given information on expected recovery timescales and when to seek further medical advice.
Numerator – the number in the denominator who were given information on expected recovery timescales and when to seek further medical advice.
Denominator – the number of people with community-acquired pneumonia.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient experience audits.
What the quality statement means for different audiences
Service providers (such as primary and secondary care services) ensure that systems are in place to give information on expected recovery timescales to people with community-acquired pneumonia, and their family and carers, if appropriate. The information should also include the symptoms to look out for that should prompt them to seek further medical advice.
Healthcare professionals (such as GPs, emergency department clinicians and other secondary care doctors and nurses) provide people with community-acquired pneumonia, and their family and carers if appropriate, with information on expected recovery timescales. The information should also include the symptoms to look out for that should prompt them to seek further medical advice. They provide this information and refer people to online resources that are available, such as the Asthma and Lung UK webpage on recovering from pneumonia.
Commissioners ensure they commission services that give information to people with community-acquired pneumonia, and their family and carers if appropriate, on expected recovery timescales and when to seek further medical advice.
People with community-acquired pneumonia and, if appropriate, their family and carers, are given information about how long their symptoms are expected to last and when they can expect to start to feel better. The information also explains which signs and symptoms they need to look out for, and when they should seek further medical attention. They are also told about online resources that may be helpful, such as the Asthma and Lung UK webpage on recovering from pneumonia.
Source guidance
Pneumonia: diagnosis and management. NICE guideline NG250 (2025), recommendations 1.10.1 to 1.10.4
Definitions of terms used in this quality statement
Community-acquired pneumonia
Pneumonia that is acquired outside hospital, or within 48 hours of admission. Pneumonia that develops in a nursing home resident is included in this definition. When managed in hospital the diagnosis is usually confirmed by chest X‑ray. [NICE's guideline on pneumonia, terms used in this guideline]
Expected recovery timescales
Parents or carers of children with community-acquired pneumonia are informed that after starting treatment their child's symptoms should steadily improve, although the rate of improvement will vary and some symptoms will persist after stopping antibiotics. For most children:
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fever (without use of antipyretics) and difficulty breathing should have resolved within 3 to 4 days
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cough should gradually improve but may persist for up to 4 weeks after discharge and does not usually require further review if the child is otherwise well.
Adults with community-acquired pneumonia, and their family and carers if appropriate, are informed that after starting treatment their symptoms should steadily improve, although the rate of improvement will vary with the severity of the pneumonia. Most adults can expect that by:
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1 week: fever should have resolved
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4 weeks: chest pain and sputum production should have substantially reduced
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6 weeks: cough and breathlessness should have substantially reduced
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3 months: most symptoms should have resolved but fatigue may still be present
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6 months: they will feel back to normal.
[Adapted from NICE's guideline on pneumonia, recommendations 1.10.1 and 1.10.2]
When to seek further medical advice
People with community-acquired pneumonia, and their family and carers if appropriate, are informed that they should seek further medical advice if the person is receiving treatment in the community or via hospital at home service and:
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symptoms worsen rapidly or significantly or
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symptoms do not start to improve within 3 days or
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the person becomes systemically unwell.
Parents or carers of children with community-acquired pneumonia are also informed to seek further advice if there is persisting fever combined with:
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increased work of breathing or
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reduced fluid intake for children or poor feeding for infants or
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unresolving fatigue.
[Adapted from NICE's guideline on pneumonia, recommendations 1.10.3 and 1.10.4 and expert opinion]