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

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 long-term condition management. (C) 2011 Primary Care Respiratory Society UK. All rights reserved. Q Zhang et al. Prim Care Respir J 2011; 20(1): 97-101 doi:10.4104/pcrj.2010.00061