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GPs buried under trusts' workload dump

Most GPs not planning on doing spirometry training despite NICE guidance

Two-thirds of GP partners and over three-quarters of salaried GPs have not obtained the spirometry certification and are either unsure about getting it, or have decided not to, according to new research.

The figures come as part of the Primary Concerns 2018 report - which surveyed nearly 3,000 GPs and other primary care staff on issues they are facing - and found 28% of partners and 49% of salaried GPs have no intention of obtaining certification to perform spirometry, while a further 34% of partners and 29% of salaried GPs are unsure about getting the certification.

In comparison, 38% of GP partners and 20% of salaried GPs said they have already have obtained certification or intend to.

In 2016, GPs were told they would have to be certified and placed on a national register by 2021, to be allowed to perform spirometry under a scheme set to be implemented by NHS England.

However, last year the BMA GP Committee said GPs do not need to undertake NHS England training requirements to perform spirometry in their practices, as it is not part of GMS, meaning local commissioners are responsible for defining what training requirements are needed.

Despite this, new NICE chronic obstructive pulmonary disease guidelines released in December said hospitals should refer patients with suspected COPD to their GP for spirometry testing.

NICE said the change will result in a small increase to GP workload, but additional spirometry referrals will have a ‘minimal impact’.

The guidance will also require practice nurses to perform lung function tests and who, according to the survey, are more responsive to adhere to the guidance. The report revealed that just over half of respondents (51%) had already gained or are planning on obtaining certification.

Only 26% of practice nurses surveyed were unsure on the certification, compared to almost one third of salaried GPs (29%) and just over a third of GP partners (34%).

The Cogora survey was open from 29 November to 20 December 2018 inclusive. Cogora offered all respondents the chance to win a £250 John Lewis voucher as an incentive to complete the survey. Cogora invited people to complete the survey through newsletters sent directly to each publication’s readers, and by way of advertisements on the publications’ website home pages. It was also promoted through the publications’ social media channels. There were 2,885 responses in total.

Readers' comments (5)

  • Why do something that is poorly funded if paid for at all.The executive need to realize there is no free lunch from GP land anymore the more they push the more likely the cheap willing horse is going to expire.

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  • Dear All,
    If there's any training needed its the NICE side of the fence rather than ours.
    Regards
    Paul C

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  • Where do you get spirometry certification if you want it?

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  • NICE is a guideline and not law, its not part of GMS either so its up to practices if they want to do it or not, some GP practices don't provide the service at all and refer to respiratory clinics. Some CCGs pay practices to perform spirometry so if you are not being paid you need to speak to your CCG as to why not. the CCG should pay for the training and certification. if not just start referring them all to respiratory teams and once they are overwhelmed the CCG will come back to you and start paying for it. they may try a private provider for a while but then when this fails it will come back to you - at this point wack up your charges so you make a profit. as it is there is no clinical evidence annual spirometry makes any clinical difference to the management of your COPD patient and is pointless. many nurses with spirometry training and certification have no idea how to manage copd patients ( been a locum for 3 years all over the UK and its bad out there) so the money would be better spent on training them on how to look after these patients properly, on which inhalers to use and when, how to recognise heart failure, mini pulmonary emboli or pulmonary hypertension - which is regularly missed -and how to use an inhaler properly. if the spirometry does not meet BTS guidelines send it back and get it done again or don't bother in the first place. i will wait till some one insists i have to do it, wait for them to provide the training and they pay for it. your a mug if you pay for it yourself.

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  • d in vadar-----absolutely spot on

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