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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)

  • This is long overdue and I am writing to the Minister to urge that all GPs should also have special training in taking a pulse and signing a Med 3. I have devised a training course lasting 3 full days each with mandatory reassessment every 3 months.
    The assessors will be paid £ 3oo per hour and the GP will pay only £200 for each certificate. Failure to mail a copy to every patient on the list will incur a fine.
    We must keep up our standards especially as there are so few of us still working.
    I will volunteer as an assessor full time and thus another GP will be lost to actually seeing patients as opposed to carrying out all these bloody silly checks!

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  • Sessional/Locum GP23 Sep 2016 4:22pm

    you failed to add that it should be part of appraisal/re-validation and requirement of good medical practice and enforced by GMC/RCGP. you also need a few politicians on your company board and then you will be good to go.

    suggested additional certification for;

    breathing - how can we assess if patient's are breathing if we haven't been assessed ourselves?

    urinating - again often overlooked is the fact that we take a history re: urinary symptoms but have we ever been trained or properly assessed and certified on this?

    i wish i was joking but i'm sure eventually some 'special' adviser i.e. a prof or lord or lady will come up with this at some point. i despair.

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  • All doctors should be assessed for relevant competences before being allowed to practise at a level expected of them.

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  • Ha ha - almost got me - its 23rd September day - the day they play the silly healthcare joke.

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  • I read the article then checked the date and laughed so hard- then I realised it isn't the 1st April. What is general practice coming to?

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  • Fookinell !

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  • Vinci Ho

    You see
    Typically , the argument is politically correct .Like what I said in the other article about NICE having a go on GPs not diagnosing enough melanoma by 2 weeks rule , one must look at the reality situation before 'driving up the standard '. You don't even have enough GPs and practice nurses to do bread and butter stuff everyday.Yes , the knowledge on how to perform and more importantly ,interpret Spirometry is variable amongst us,GPs. But really we did not ask for it in the first place . The ultimate consequence is everybody just refers to secondary care for spirometry unless you have a GP with extended interest allocated to each locality of a group of practices . Obviously , we will then be penalised for referring too many !
    Depending on how complex the training requirements are to obtain this certificate, this ,kind of ,paves the road of PACS and MCP . Only the super or mega- practice can have certified GPs or specialists for Spirometry.
    As I said , the difference between being down to earth and up there above the ground.......

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  • Presumably our hospital Respiratory colleagues will also have to leap through the same pointless hoops?
    Perhaps our Consultant cardiology colleagues should be asked to undertake regular training in the interpretation of ECGs?
    Madness. Where has the trust in professionals gone?

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  • What is the point in studying for decades and racking thousands in debt when nobody trusts you to perform at the end of it?

    No time for this certification, accreditation, revalidation and other suck bollocks. Just refer.

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  • What about ECG's or using a patellar hammer or a stetoscope or an opthalmoscope or taking a history
    Let's have certificates for all these
    You can damage patients just as much with wrongly using or doing any of these
    God give me strength

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