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

作者：Worth Allison^*; Pinnock Hilary; Fletcher Monica; Hoskins Gaylor; Levy Mark; Sheikh Aziz

来源：Primary Care Respiratory Journal, 2011, 20(1): 23-32.

DOI：10.4104/pcrj.2010.00070

• United Kingdom
• respiratory disease
• primary care
• management
• systems
• policy
• funding

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.

• 出版日期2011-3