Respiratory illnesses present commonly to primary care teams, and represent over one third of acute medical intake in most Scottish hospitals. The ageing population, advances in primary and secondary prevention of cardiovascular diseases, and improvements in acute and chronic management for respiratory complaints means the pressures placed on secondary care respiratory units is far greater than ever before. Ensuring people see the right health care professional, in the right setting, at the right time, continues to be demanding. We face challenges of prioritisation of those people with serious illnesses; providing access to diagnostic testing to allow primary care clinicians to make independent decisions about their patients; streamlining referral pathways; and providing high quality ongoing care for people with chronic respiratory disease.
Pulmonary malignancy is a clinical priority covered by other guidance. Of the other respiratory complaints asthma, COPD, idiopathic pulmonary fibrosis, bronchiectasis and obstructive sleep apnoea syndrome make up the majority of the workload of respiratory physicians in Scotland. Although each presents its own challenges, there are problems common to all respiratory conditions. There is a strong evidence base for these conditions, and straightforward measures that can be taken to improve outcomes.
Dr Tom Fardon
Consultant Respiratory Physician