Primary Care Respiratory Journal

Volume 20 Issue 1 March 2011

Review

Systems for the management of respiratory disease in primary care – an international series: United Kingdom

Pages 23-32
^*Allison Worth^a, Hilary Pinnock^a, Monica Fletcher^b, Gaylor Hoskins^c, Mark L Levy^a, Aziz Sheikh^a

^aAllergy & Respiratory Research Group, Centre for Population Health Sciences: General Practice Section, The University of Edinburgh, Scotland

^bEducation for Health, Warwick, UK

^cDivision of Clinical & Population Sciences & Education, University of Dundee, Scotland

Received 18 May 2010 • Accepted 4 August 2010 • Online 5 November 2010

Abstract
INTRODUCTION: The UK National Health Service (NHS) is essentially publicly funded through general taxation. Challenges facing the NHS include the rise in prevalence of long-term conditions and financial pressures. NATIONAL POLICY TRENDS: Political devolution within the UK has led to variations in the way services are organised and delivered between the four nations. PRIMARY CARE RESPIRATORY SERVICES IN THE UK: Primary care is the first point of contact with services. Most respiratory conditions are managed here, including prevention, diagnosis, treatment and palliative care. EPIDEMIOLOGY: Respiratory disease accounts for more primary care consultations than any other type of illness, with 24 million consultations annually. ACCESS TO CARE: Equitable access to care is an ongoing challenge: telehealthcare is being tried as a possible solution for monitoring of asthma and COPD. REFERRAL AND ACCESS TO SPECIALIST CARE: Referrals for specialist advice are usually to a secondary care respiratory physician, though respiratory General Practitioners with a Special Interest (GPwSIs) are an option in some localities. CONCLUSIONS: Prevalence of asthma and COPD is high. Asthma services are predominantly nurse-led. Self-management strategies are widely promoted but poorly implemented. COPD is high on the policy agenda with a shift in focus to preventive lung health and longterm condition management.

Cite as: Worth A, Pinnock H, Fletcher M, Hoskins G, Levy ML, Sheikh A. Systems for the management of respiratory disease in primary care - an international series: United Kingdom. Prim Care Respir J 2011;20(1):23-32. DOI: http://dx.doi.org/10.4104/pcrj.2010.00070

Keywords
United Kingdom, respiratory disease, primary care, management, systems, policy, funding

* Corresponding author. Allison Worth Tel: +44 (0)131 650 9463 Fax: +44 (0)131 650 9119 Email: Allison Worth@ed.ac.uk

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