Spirometry is an important part of the diagnostic and monitoring pathways for respiratory disease.

There have been concerns about the local differences in its commissioning. NHS England released training standards which will make the provision of spirometry more difficult.

What you need to know

• Spirometry being an item within QOF does not define it as part of general medical services.
• In many areas spirometry is delivered through a local enhanced service.

• Commissioners have the right to define what training requirements are needed.
• The price of the contract should be set at a level that provides the practice with income once the costs of staffing, training, equipment and infrastructure are paid.
• Where these are not met practices are under no obligation to provide the enhanced service and the CCG assumes responsibility.

• In areas where spirometry is not commissioned through an enhanced service, it is up to commissioners to ensure it is available to patients.
• Where practices are not specifically commissioned for spirometry but wish to do so, partners are responsible for ensuring ensuring that staff are appropriately trained.
• Even though there is no such thing as ‘mandatory training’, it may be that the CQC will look for standards in line with NHS England.
• We would encourage practices to regularly review their services.
• If a practice decides to stop providing a service which is non-contractual they must give notice to their CCG for alternative arrangements to be put in place. There is no formal definition of the length of notice.