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GPs will need certification to carry out spirometry by 2021

GPs will have to be certified and placed on a national register to be allowed to perform spirometry under a new scheme set to be implemented by NHS England over the next five years, GP respiratory leads have announced.

The certification scheme – set up with the help of the UK Primary Care Respiratory Society (PCRS-UK) and other expert groups – will mean GPs and practice nurses will have to demonstrate they can perform and interpret spirometry to standards set by the Association for Respiratory Technology and Physiology (ATRP) in order to continue carrying out the lung function tests.

Pulse revealed the scheme was in the pipeline three years ago, following concerns spirometry was ‘sub standard’ in some GP surgeries and leading to as many as two in five people potentially being misdiagnosed with COPD.

The idea raised hackles among some GP experts at the time, who warned certification was over the top and that the limited resources in primary care could even force GPs to stop doing the diagnostic tests.

But GP respiratory experts supporting the ATRP certification scheme told Pulse they believe these concerns have been addressed by planning a phased introduction that means it won’t come into full effect until 2021.

NHS England’s document outlining the scheme explains that GPs already experienced in spirometry can choose to undergo extra training if they need to, before undergoing an assessment by an 'ARTP approved assessor’.

Once certified, GPs will also need to show they are keeping up their competency every three years, with an observed assessment and submission of a ‘comprehensive portfolio’.

The portfolio will ‘include evidence of continued calibration, quality assurance and infection control procedures, evidence of quality spirometric measurements and where interpretation is required, an analysis of five spirometry traces provided by the ARTP to review for technical quality and interpretation’, the document states.

But it adds that ‘to allow sufficient time for the necessary training, assessment and certification infrastructure to be set up, it is proposed to phase the implementation of the recommendations over the four years 1 April – 31 March 2021’.

Dr Stephen Gaduzo, a GP in Stockport and former chair of PCRS-UK, who helped develop the programme said: ‘In many ways, this is formalising and standardising best practice. Healthcare staff are undertaking spirometry currently after taking a range of different training routes, and some may have had little or no formal training.

‘PCRS-UK welcomes this scheme as it will promote the performance and interpretation of spirometry to a consistent high standard by requiring staff to demonstrate their competence in order to join the national register.’

Dr Duncan Keeley, a GP in Oxfordshire who is on the PCRS-UK executive, told Pulse: ‘There are understandable concerns in the general practice community that there is a problem if every procedure done in primary care requires specific and repeated training and certification.

‘But I think there is a need for improvement in standards in spirometry [and] the document has got a long period over which it needs to be implemented, which I think that is very sensible given the current and ongoing financial constraints and the need for better training’

GPs are already required to make sure they perform spirometry to confirm COPD diagnoses under QOF, and are also coming under pressure to use the lung function tests more routinely in diagnosis of asthma.

Readers' comments (59)

  • Not enough red tape yet. NHSE will next want you to be on 'National register' - (where did that come from?)- for doing rectal examinations and even auscultations.
    National register hmmm.... sounds more ominous than a 'GPs to the flames' register - another Werwolf plan?

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  • Refer to respiratory team for enhanced breathing tests. Job done. Good thing I don't wear a cardigan.
    Item of service payment is a different conversation.
    We could bring ccg crashing down with more debt and hospitals even more unable to deliver opd assessment. I am trying to make my job sustainable. Joining transform.

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  • Am I wrong, but is not the recording and interpretation of spirometer included in the MRCGP curriculum and as such I have been trained and assessed already? Just a thought. Maybe I should go on a course on blood pressure recording or ECG interpretation next.

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  • Made me laugh that "...concerns have been addressed by planning a phased introduction that means it won’t come into full effect until 2021." So, concerns are addressed merely by putting it into the future?

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  • Sanjeev Juneja | GP Partner23 Sep 2016 12:45pm
    I think this already exists. The national register for being rectally examined by NHSE is called the GMC register. Now kindly bend over.

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  • Really don't know why I bothered doing a degree in medicine. It is pretty much worthless, or will be soon. Sad that it's other GPs contributing to these decisions.

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  • and let me guess who will have to pay for the course and certification etc etc......

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  • Absolutely awful. I do not have much to add except that I agree to all of the above comments, especially Sanjeev Juneja's comment about P.R. examinations. I presume GPs will be attending Medical School next, and having to pay for it. So why don't GPs do something about this nonsense,? Because of blackmail. The micromanagers mantra, is do this or else you do not get paid. Maybe they need a P.R. exam using several fingers.

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  • Yup, fine, as above. Not GP work, no interest in doing so refer all.

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  • How about using a stethoscope? we need training in that too.

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