title: Management of COPD in primary care in north-east Scotland.
abstract: BACKGROUND
  We wished to obtain a snapshot of current service provision and how this could best be developed approximately one year on from the introduction of the National Institute for Clinical Excellence (NICE) guidelines for the management of chronic obstructive pulmonary disease (COPD) and the inclusion of COPD care in the New GMS Contract Quality and Outcomes Framework (QOF).
  
  
  METHODS
  A questionnaire-based survey sent to every general practice (n = 84) in Grampian.
  
  
  RESULTS
  Responses were received from 75 of 84 practices (89%). Questionnaires were returned by both general practitioners (GPs) and practice nurses in 45 practices (54%). All responding practices reported that they had COPD registers. 60/75 (80%) of practices reported having a dedicated COPD clinic; 70/75 (93%) had a spirometer. Areas identified for service development were: quality assuring training in COPD care and spirometry; expanding pulmonary rehabilitation provision (86%), delivering this service locally (54%) and in primary care (75%); standardising referral, assessment and communication about provision of home oxygen; training in pulse oximetry (71%).
  
  
  CONCLUSIONS
  This data has important implications for the validity of the quality indicators (QOF) under the new GMS contract. Our respondents identified areas where the new GMS contract QOF could be improved, as well as providing useful suggestions for service development. Respondents recognised that not all clinical services can be effectively delivered by general practice with data supporting the development of intermediate care services for people with COPD.
authors.affiliation: Department of General Practice and Primary Care, Foresterhill Health Centre, Westburn Road, University of Aberdeen, AB25 2AY. jen.cleland@abdn.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Cleland
authors.forename: M
authors.initials: M
authors.lastname: Mackenzie
authors.forename: I
authors.initials: I
authors.lastname: Small
authors.forename: G
authors.initials: G
authors.lastname: Douglas
authors.forename: I
authors.initials: I
authors.lastname: Gentles
mesh_terms: D006801:Humans; D010092:Oximetry; D010102:Oxygen Inhalation Therapy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000628:therapy*; D012606:Scotland; D016540:Smoking Cessation; D013147:Spirometry