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 longterm condition management. © 2011 Primary Care Respiratory Society UK. All rights reserved.