Chronic obstructive pulmonary disease affects about 1% of the total UK population1 and is a major cause of disability and mortality worldwide. Timely diagnosis and subsequent staging of severity of disease both require spirometry, which in theory can be performed by trained general practitioners (GPs) and their practice staff.²³ However, numerous barriers impede the implementation of spirometry in primary care.

Several guidelines exist for the management of patients with chronic obstructive pulmonary disease, including those from the UK National Institute for Health and Clinical excellence (NICE)4 and the Global Initiative for Chronic Obstructive Lung Disease (GOLD; http://www.goldcopd.com/). All guidelines stress the central role of spirometry in diagnosing and managing the disease in primary care, …