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

Prim Care Respir J. 2011 Mar;20(1):23-32. doi: 10.4104/pcrj.2010.00070.


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.

Publication types

  • Review

MeSH terms

  • Cost Savings
  • Delivery of Health Care / organization & administration
  • Female
  • Health Care Costs*
  • Health Planning
  • Health Policy
  • Humans
  • Male
  • National Health Programs / organization & administration
  • Practice Guidelines as Topic*
  • Primary Health Care / organization & administration*
  • Program Development
  • Program Evaluation
  • Quality of Health Care
  • Referral and Consultation / standards
  • Referral and Consultation / trends
  • Respiratory Tract Diseases / diagnosis
  • Respiratory Tract Diseases / therapy*
  • State Medicine / organization & administration*
  • United Kingdom