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Citation

Worth A, Pinnock H, Fletcher M, Hoskins G, Levy ML & Sheikh A (2011) Systems for the management of respiratory disease in primary care - an international series: United Kingdom. Primary Care Respiratory Journal, 20 (1), pp. 23-32. https://doi.org/10.4104/pcrj.2010.00070

Abstract
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.

Keywords
United Kingdom; respiratory disease; primary care; management; systems; policy; funding

Journal
Primary Care Respiratory Journal: Volume 20, Issue 1