Management of COPD in primary care in Leicestershire.

Aim: To determine the proportion of general practices in Leicestershire, UK, with the resources to provide high quality COPD care.
Methods: A postal survey of all 147 Leicestershire practices with postal and telephone follow up.
Results: The response rate was 65%. 45 practices (47%) had COPD registers, 44 practices (46%) had COPD protocols and eight practices (8%) had COPD clinics. 52 practices (54%) owned one or more spirometers and 13 (15%) had at least one person with current (within the last two years) approved/formal training in performing spirometry. Four practices (4%) had COPD protocols, registers and clinics and trained operators with current training.
Discussion: Very few practices have the resources to provide high quality care of COPD in the practice. Maintenance of current approved training for spirometry operators is likely to be a major and continuing barrier to providing such care. This may be best provided at locality level by intermediate care.