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Ensuring patients receive high quality diagnostic spirometry: a new national register

The respiratory community and NHS England have collaborated to develop a new scheme launched today to support the training and competency assessment of those performing and /or interpreting diagnostic spirometry. Healthcare practitioners in England who demonstrate that they are competent to perform and/or interpret spirometry and will be able to join a new national register of certified practitioners.

Diagnosing respiratory disease accurately can be a real challenge, and there is much debate about whether there is underdiagnosis and overdiagnosis of respiratory conditions. So we should welcome any initiative which seeks to improve the chances of a patient getting an accurate diagnosis’, stated Judith Lawrence, a practice-based advanced nurse practitioner from North Shields who represented PCRS-UK in this work. ‘Making sure that everyone undertaking spirometry is competent will enable us to be more confident that we are getting diagnosis right, so that we can get patients started on the right treatment.’

 ‘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’, commented Stephen Gaduzo, GP in Stockport and former chair of Primary Care Respiratory Society UK (PCRS-UK) who also represented PCRS-UK in developing the new scheme. ’PCRS-UK has worked closely with colleagues in ARNS, ARTP, BLF, BTS, Education for Health and NHS England, to come to this consensus.’

The new scheme sets out how healthcare professionals performing and/or interpreting diagnostic spirometry should be trained, assessed and certified. The new arrangements will be phased in over 4 years up to 31 March 2021 to allow sufficient time for the necessary training, assessment and certification infrastructure to be set up.   

PCRS-UK's priority in contributing to the scheme has been to ensure that the scheme is practical, realistic and can be implemented in primary care where the majority of diagnostic spirometry takes place.  Importantly, the new scheme: 

  1. Recognises the distinct and separate skills of performing spirometry, interpreting spirometry, and diagnosing respiratory conditions where spirometry results form part of the whole picture.
  2. Enables those practitioners who are experienced and confident in either performing and /or assessing spirometry and consider themselves competent, to be assessed and certified through an experienced practitioner scheme
  3. Supports those practitioners, who are less confident about their skills, to access the appropriate training
  4. Recognises that providing a good diagnostic spirometry service may take different forms in different places and is not prescriptive about the setting in which spirometry takes place.

Noel Baxter, Chair of PCRS-UK says, ‘We believe the creation of a National register for all professionals performing or interpreting spirometry will lead to better, more accurate diagnostic spirometry wherever it is performed, by healthcare practitioners who are well trained, competent and confident. If this leads to patients having a more accurate diagnosis and ultimately improved care and better clinical outcomes, we will have succeeded. We commend this to all our colleagues in general practice’.

 More information can be found at:-

  • Improving the quality of diagnostic spirometry in adults: the National Register of certified professionals and operators.  See HERE (full publication)
  • Frequently asked questions - See HERE
  • Summary leaflet - See HERE
  • Summary Powerpoint™ slides that can be used, for example, at meetings- See HERE
  • A guide to performing quality assured diagnostic spirometry - See HERE

Relevant PCRS-UK resources:-

  • PCRS-UK Pull-out wall chart guide to spirometry September 2015 See HERE
  • Quick guide to the diagnosis and management of COPD - See HERE 
  • Quick guide to the diagnosis and management of asthma - See HERE 



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Clinical Area: 
Respiratory tests and investigations
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