A centralised respiratory diagnostic service for primary care: a 4-year audit.

Background: The literature shows that delayed or erroneous diagnosis of respiratory conditions may be common in primary care due to underuse of spirometry or poor spirometric technique. The Community Respiratory Assessment Unit (CRAU) was established to optimise diagnosis and treatment of respiratory disease by providing focused history-taking, quality-assured spirometry, and evidence-based guideline-derived management advice.

Aims: To review the service provided by the CRAU to primary care health professionals.

Models to enhance research capacity and capability in clinical nurses: a narrative review.

Aim: To identify models used as local initiatives to build capability and capacity in clinical nurses.

Background: The National Health Service, Nursing and Midwifery Council and the United Kingdom Clinical Research Collaboration all support the development of the building of research capability and capacity in clinical nurses in the UK.

Design: Narrative review.

Smoothing the passage of patients from primary care to specialist respiratory opinion.

Aims: To assess whether information in general practitioner (GP) referral letters provides a basis for selection of diagnostic tests in patients referred for specialist respiratory advice.

Methods: We undertook a prospective study within a respiratory outpatients department to compare the diagnostic tests planned at three stages of the referral/specialist consultation process: i) using the GP referral letter alone; ii) using the referral letter and patient history; iii) using the referral letter, patient history, and clinical examination.

Results: Analysis of the content of GP referral letters revealed wide variations in referral information.