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


BACKGROUND
Respiratory disease accounts for more primary care consultations than any other type of illness, with 24 million consultations annually.
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.
Allergy & Respiratory Research Group, Centre for Population Health Sciences: General Practice Section, The University of Edinburgh, Scotland, United Kingdom. allison.worth@ed.ac.uk
Allison
A
Worth
Hilary
H
Pinnock
Monica
M
Fletcher
Gaylor
G
Hoskins
Mark L
ML
Levy
Aziz
A
Sheikh
D017046:Cost Savings; D003695:Delivery of Health Care / Q000458:organization & administration; D005260:Female; D017048:Health Care Costs; D006285:Health Planning; D006291:Health Policy; D006801:Humans; D008297:Male; D009313:National Health Programs / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000592:standards / Q000639:trends; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000628:therapy*; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom