This report contains the main messages and key recommendations derived from an analysis of data collected for the adult asthma and chronic obstructive pulmonary disease (COPD) organisational audit component of the National Asthma and COPD Audit Programme (NACAP). Data collection for the organisational audit took place between 1 April and 1 July 2019 across England, Scotland and Wales. The audit collected information on the resourcing and organisation of services relevant to the care of adult patients with asthma and COPD that are admitted to hospital.