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By Daniel Cressey

A third of respiratory referrals could be handled by GP specialists, new research suggests.

Respiratory experts said

GPwSI clinics could substantially cut hospital referrals ­ but warned that respiratory disease had become a neglected area of medicine.

All three members of an assessment panel agreed GPwSIs could have managed 23 per cent of referrals to a hospital respiratory clinic.

In a further 12.5 per cent of cases, two of the three assessors felt GPwSI management would have been appropriate.

Only 42 per cent of referrals were unanimously deemed unsuitable for a GPwSI clinic, with partial agreement of unsuitability or lack of patient information in the remainder of cases.

Study leader Dr Richard Gilbert, a GPwSI in respiratory medicine in Norwich, said: 'There is the potential for respiratory GPwSIs to play a role in most PCTs. Selecting patients for a GPwSI service could save funds for use elsewhere.'

He said clinics were more convenient for patients, could be accessed more quickly and offered better patient education.

Professor David Price, professor of primary care respiratory medicine at the University of Aberdeen, said: 'There is plenty of scope for GPwSI clinics.'

Professor Price, who published a study recently finding only 6 per cent of primary care organisations had respiratory GPwSIs, added: 'The message is starting to get through but this data does help. Every PCT should look at this.'

Dr Mike Dixon, chair of the NHS Alliance, said: 'Respiratory disease has been left out a bit because there hasn't been an NSF and it didn't feature so highly in the QOF.'

The Department of Health said: 'We certainly agree more patients could be seen in primary care. Three-quarters of referrals for some conditions could be seen by a GPwSI.'

In the study, published early online by the Primary Care Respiratory Journal this week, two GPs and a consultant respiratory physician assessed 96 referral letters to Norfolk and Norwich University Hospital's department of respiratory medicine.

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