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COPD Annual Assessment

petercr profile image
70 Replies

Just attended my GP for an annual COPD assessment and been advised that they no longer conduct lung function tests (Spirometry) due to NHS advice , infection risks & COVID. According to the Nurse Practicioner this had been the case for nearly three years. When I indicated that I found the Spirometry, and in particular annual FEV1 results useful understanding if my condition was stable or not, she said there was nothing they could do.

Is this just local GP BS or have other members had a similar experience??

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petercr
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70 Replies
knitter profile image
knitter

I had a text from my health centre last week to say spirometry tests starting again , and I could go on the list .

Davegt profile image
Davegt in reply to knitter

I had a test on 5th July 2023. They have been starting up again but a new covid virus has appeared quite recently that may change things. You cannot blame the staff if a decision is made to suspend testing. They have to follow the guidelines which are there to avoid transmission through spirometry tests. There is no point in patients saying they insist on a test if they cannot be done.

Davegt profile image
Davegt in reply to knitter

Sorry my last message was a general response and not directed to you specifically. Oops!

CDPO16 profile image
CDPO16

My surgery still isn't doing spirometry tests and reviews are by telephone.

helenlw7 profile image
helenlw7

I have a lung function test booked at my local hospital for March next year.

Ern007 profile image
Ern007

i have COPD annual reviews at GP - My last Spirometry was 4 years or over ago - They was going to stop Spirometry, as it made me pretty dizzy the last couple of times, but I think before I stopped. Spirometry, was stopped anyway. I had it for years and years, but not anymore.

Turnipgirl profile image
Turnipgirl

I had spirometry at outpatients back in 2018 after a blood clots in the lungs and its a horrible test when you have to blow into the machine!

Thankfully my spirometry was normal and I got discharged from the clinic and cried in relief!

Annscottie profile image
Annscottie

Hi petercr

No spirometry test. Text to tell me to fill in an online form. Sometimes a follow up phone call. My last spirometry was before the pandemic. Feel pretty 'ignored' to be honest!

Davegt profile image
Davegt in reply to Annscottie

You are not being ignored, please don't feel that way. There has been a ban on spirometry tests because of covid. That ensures the virus is not passed on during tests. In more recent times many surgeries have started doing tests again, initially for new patients and then gradually for all. Sadly another covid virus has appeared in many countries, including UK. This is likely to put testing on hold again. No individual is being "picked on". Surgeries would not wish to be responsible for causing any spread through spirometry tests.

Annscottie profile image
Annscottie in reply to Davegt

An online form and sometimes a follow up phone call is poor.

I don't feel picked on nor doI need a spirometry test to tell me how my chest is doing. I was simply telling the OP that I hadn't had spirometry and how my practice has monitored me in recent years.

Davegt profile image
Davegt in reply to Annscottie

Well you did say you felt pretty ignored. I was attempting to explain what is going on currently. Whatever I say you criticise and disagree. I explain why things are as they are. Obviously you are unhappy but in the present climate all medical staff have to follow directives. To avoid further discussion I will not respond further as whatever I say you disagree with.

syntax profile image
syntax in reply to Davegt

They are just plucking at strawa,because they have know idea what spreads it and what does not. There are so many people with C.O.P.D. that they need to centre on that, these are the people with more chance of getting COVID.

Davegt profile image
Davegt in reply to syntax

We have to disagree on this. That is not the case. The spike protein is the key to transmissability and they are now able to analyse the amino acids and determine whether a mutation will attach more easily. Obviously this is a very technical subject and to say "they are clutching at straws" is an inappropriate remark that does not appreciate work scientists are doing.

syntax profile image
syntax in reply to Davegt

So why are people with C.O.P.D. classed with the " most at risk "

Davegt profile image
Davegt in reply to syntax

I am just about to go out so don't have a lot of time. Attitudes and opinions of clinically extremely vulnerable (CEV) people. From September 2021, people previously identified as clinically extremely vulnerable (referred to in this bulletin as “CEV people”) were no longer advised to shield, and the shielding programme ended.13 May 2022.

I think the emphasis now is more on organ transplants or immune system compromised.

Apologies if this is not correct but i am in a hurry. Take care 🙂

syntax profile image
syntax in reply to Davegt

Transplants. It would take a miracle these days to be able to get one be it heart ,lungs or anything else.This country I believe does four (FOUR) a year.

Davegt profile image
Davegt in reply to syntax

Thanks to our amazing donors, we were able to facilitate nearly 4,600 transplants in 2022/23. This is fantastic, but there is still lots to do. We estimate there to be around 7,000 people on the UK Transplant Waiting List. Last year over 430 people died while waiting for a transplant.

hypercat54 profile image
hypercat54

Mine said exactly the same thing. They said they only refer if they suspect something else is wrong. The nurse (only see a copd nurse, never a doctor) said they can see the damage done.

My next one is due next Jan/Feb so am going to put them on the spot and ask them whether I have chronic bronchitis, emphysema or both and exactly what stage I am at lol. And am going to think of as many technical questions as I can. I won't make it easy for them to refuse me a spirometry!

I am also going to check I have an experienced respiratory nurse and not a trainee as last time I had to go twice! Not on.

clematis5932 profile image
clematis5932 in reply to hypercat54

I go the the Respiratory Clinic at the Hospital every three months and see the Consultant every six months. I was told by respiratory that new patients have to have had three either Infections or Acerbations' of which your GP has given treatment before being referred to one or the other. She also said that a spirometry alone would not give you a diagnose of your condition. My spirometry is done eah time i go to respiratory clinic but is done standing Infront of a large machine. There are other breathing tests given at the same time depending on the results of spirometry My surgery stopped doing doing these tests during Covid plus ear syringing and say they will not go back to them.

Annscottie profile image
Annscottie in reply to hypercat54

First time I saw a nurse at the surgery in 2010, after tests etc at hospital where I was given the COPD & bronchiectasis diagnosis , she said to me I'm a midwife not respiratory so don't really know what I'm doing! 🙄

Good luck hypercat!

Davegt profile image
Davegt in reply to hypercat54

A spirometry test cannot distinguish between emphysema and chronic bronchitis.

Annscottie profile image
Annscottie in reply to Davegt

No but HRCT scans can!

Davegt profile image
Davegt in reply to Annscottie

Of course they can. But my reply was to hypercat54, who suggested she would ask at her doctors whether she has emphysema or chronic bronchitis.

Annscottie profile image
Annscottie in reply to Davegt

My mistake. I didn't read who your reply was to and just saw it after my post. Sorry!

Davegt profile image
Davegt in reply to Annscottie

That's ok. But I think I will end now as we do not agree and I do feel for the medical staff who must receive much criticism. Good night.

Patk1 profile image
Patk1

I've had lft done in past 15mths at hospital

Danielmystar profile image
Danielmystar

Hi its the same where I am but they stopped doing it before covid etc I come under lancaster & morecambe Bay practice but I had a nurse calling to me this year who managed to get me an appointment for spirometry test I was upset by results but this group put me at ease either way I agree with you its helpful to have a spirometry test regardless of the outcome I was told they no longer do the test as some patients don't like having it but hey what about us the ones who find it helpful x

suef profile image
suef

I had a spirometry two weeks ago. Obviously during the pandemic we could'nt. X

Lynnetp profile image
Lynnetp

Hi, I’ve just done a full lung function test at my local hospital. I’m in the West Midlands and so don’t know about other regions but the service is up and running here.

Welshcatlady profile image
Welshcatlady

I haven't had a Spirometry test since b4 Covid, haven't asked why, so I'm guessing what you said is right.

Pippydo profile image
Pippydo

I’m in East Midlands and have full lung function tests every 4 months then see consultant about a month later to discuss results, this is done at hospital rather than GP, seems like a bit of a lottery depending on where you live maybe every place different.

whit profile image
whit

Not had one since covid. that's docs and 6 stints in hospital.

PaulineHM profile image
PaulineHM

According to NICE spirometry is now only carried out to diagnose lung conditions rather than already diagnosed conditions, because level of function is more helpful than FEV1

My personal view is that it may be helpful for some people ie those who give up tobacco- they may see an improvement in FEV1.

Hope this is helpful ?

Go well,

Pauline

B0xermad profile image
B0xermad

I had a gp telephone assessment 2weeks ago they just read from a sheet and tick boxes. But recently went to respiratory hospital appointment for yearly check and was called back Monday for a spirometry which surprised me although I have to wait until next year for the results

Stanjory profile image
Stanjory

Yet again we’re seeing inconsistent practices across the country! This is similar to the different approaches to prescribing rescue packs and changing to salamol for example. I’ve just had my 2nd annual basic spirometry test with my surgery since covid. The message seems to be they now focus on the here and now and how you’ve been in the previous year. They are less interested in changes in numbers from year to year.

Bingo88 profile image
Bingo88

Sounds like something only your surgery has decided to do. So how are they going to check if your lung function is getting worse or better then. I had a Spirometry blow test 4 months ago. I should ask if they are going to refer you to a hospital department then. Brian

tomc profile image
tomc

It is not just GPs. My hospital has told me my next consultation is to be a phone call AND my pain clinic was due for today at 11am and a phone call an hour ago to say that this will be a phone call instead of face to face...... sick as a parrot I am.

Davegt profile image
Davegt in reply to tomc

Obviously this is very frustrating for you. However with a new Covid variant now in the UK, caution is the word. This version is very transmissible but as yet it has not been determined how virulent it is. Many of the more recent variants have been similar to a common cold. However this latest variant is still being studied. Like all countries we were caught out at the beginning and hopefully we are wiser now. Many, especially older and vulnerable people lost their lives and funerals could only be attended by few people. We hope this latest variant, although easily transmitted, is not virulent. For the time being it makes sense that trips to hospitals are avoided where possible. Obviously a phone call is not ideal but for the moment does make sense. I imagine that, if the phone call raised very serious concerns, a face to face would be arranged.

tomc profile image
tomc in reply to Davegt

I agree with that but, It is very frustrating when you are constantly in pain and that pain mostly in the tongue BY biting it. 😅

Davegt profile image
Davegt in reply to tomc

The only consolation is we are all in the same boat.

tomc profile image
tomc in reply to Davegt

United we stand! unless our legs give way.. then it`s Deflated we all faw doon!!

Davegt profile image
Davegt in reply to tomc

Lol. Well keeping a sense of humour does help. Take care. 👍

Tykelady profile image
Tykelady

I was told the same thing.

katiepudding2 profile image
katiepudding2

I've had phone consults both with my GP and hospital chest unit.

This year the hospital also sent me for a spirometry test as they said it was overdue. I had to chase the results up though. Also asked hospital why my GP refuses to supply rescue packs and he seemed to agree with the GP that they aren't necessary.

GP pharmacist prescribed a third inhaler Incruse ellipta in addition to my fostair and salbutamol but I didnt use it as wanted to ask the hospital when they gave me the spirometry results. The hospital phone appt doctor prescribed I think serevant but not sure as not yet collected it. I haven't had a face to face for three years, either with GP or hospital.

Davegt profile image
Davegt in reply to katiepudding2

In the past, rescue packs were often issued as a matter of course. However, in more recent times doctors and specialists have realised that exacerbations are often caused by a virus and not bacteria. Antibiotics do not work with a virus. Over time many bacteria have adapted, meaning that many antibiotics no longer deal with bacteria. These bacteria are known as superbugs and over time more and more bacteria cannot be killed with antibiotics. As a result decisions have been made to not issue antibiotics until it is confirmed that bacteria are the cause. A sputum sample can determine this. But many having an exacerbation want antibiotics NOW. But if it is a virus they won't help. This is a dilemma but many current diseases that 1 weeks antibiotics can treat, may become untreatable. That can lead to very serious complications or death. What is the correct policy, I do not know.

katiepudding2 profile image
katiepudding2 in reply to Davegt

I'm aware of the ongoing debate about superbugs and antibiotic resistance and viruses - I worked for years as a Registered Nurse. Its not new, been going on for years.

Davegt profile image
Davegt in reply to katiepudding2

Oh. With you asking hospital why your GP refuses to issue rescue pack, that suggested to me that you may not be aware. Anyway as you are, you appreciate the dilemma.

Yoga2011 profile image
Yoga2011

I’ve just been referred to the respiratory clinic at my hospital and assumed I’d get lots of tests to get diagnosed properly. I’m wondering now what I’ll get!

leo60 profile image
leo60

Hi all :) I have only ever had spirometry done once, on diagnosis. Is it only me, but I (and indeed my consultant) feel no need to have my disease (emphysema) quantified? I am treated by my symptoms not by numbers. I don't know 🤷‍♀️ maybe I'm just a bit laid back about it or am I missing something?!😂

Anyway, all the best folks xx

patty17 profile image
patty17

Hi petercrMy GP has stopped doing the spirometry tests as well.

They stopped about 3 years ago.

Ergendl profile image
Ergendl

Like you, I haven't had a spirometry test since before Covid. I use my own equipment to check my breathing, bought from Amazon.

Biker88 profile image
Biker88

I had my annual review 4 weeks ago including the lung function tests, it’s only an indication if your lungs are better or worse. I check mine at home with an Amazon asthma meter which measures PEF and FEV, I also check my temperature, use a pulse oximeter and BP monitor. Useful just to make sure every thing is ticking over ok. My GP doesn’t do lung function tests thats left to the respiratory team at the hospital

pepparuby1 profile image
pepparuby1 in reply to Biker88

Yes me too

kenta profile image
kenta in reply to Biker88

I have asthma and bronchiecstasis. What is an Asthma meter? At which % on my oximeter should I be concerned?

Biker88 profile image
Biker88 in reply to kenta

It’s Amazons name for a peak flow meter which also measures FEV as well as PEF. Oximeter readings depend on the level individual, the normal for healthy person is 98/99, mine is usually about 95/96 resting and will drop below 90 on exertion but it does come back up again when exertion stops. If your normal is 98/99 and it drops to 93/94 and stays there then check with a doctor, you could call 111 and ask for advice if it’s not easy to see your doctor.

kenta profile image
kenta in reply to Biker88

Thank you! Stay well !

Poppy2525 profile image
Poppy2525

I have just been for my annual COPD assessment at my local doctors and they said the same, what a load of rubbish, before Covid came along weren't there other illnesses that could have been caught. All part of saving money. All they did was ask a few questions which they could have done over the phone and saved us both a lot of time

Cloudancer profile image
Cloudancer

I had spirometry done 2 1/2 years ago whilst restrictions still in place at my hospital.Personnel in full PPE everything meticulously wiped down and sanitized.

The only difference was that the technician was a locum.

Good luck with getting sorted .

pepparuby1 profile image
pepparuby1

wow!!! I had no idea!! I haven’t ever had spirometer tests at the GP and diagnosed 14 years ago! The respiratory nurse asks a load of questions before you attend.

However…. I’m fortunate enough to be a regular for clinical trials where I have loads of tests so thank god for that!

I also purchased my own spirometer from Amazon and check my breathing at home.

I seriously had no idea they weren’t doing them in gp surgery’s . I’ve got a medication review in January which I booked in myself

Turnipgirl profile image
Turnipgirl in reply to pepparuby1

I had a medication review back in September when they said they are very pleased with me and how the repeated blood test I had just before I moved back in May was perfect and no problems there which was excellent!

Since I moved back in May I feel it's no happy accident that my health has improved a great deal and I ended up saying how I'm glad the old place has gone as I reckon it was cursed!

Baby is looking forward to her Christmas presents next Monday and we are looking forward to a few relaxing days off!

Hows Pepparuby the black panther getting on and Hector?

pepparuby1 profile image
pepparuby1 in reply to Turnipgirl

Your old place could have affected your health - mould etc

Pepparuby is lovely and like Baby she’s looking forward to Christmas and presents

Turnipgirl profile image
Turnipgirl in reply to pepparuby1

What I feel was the main problem that affected me at the old place was noise more than anything else.

There was the time just before I was about to start that pharmacy job the following day when I had fancied a quiet afternoon but it wasn't to have been as upstairs there had been a noisy party and I had got so fed up that I got a Broom and banged on the ceiling!

I wouldn't have banged for regular living sounds though!

Here it's nice and quiet with hardly any noise!

Yeo58 profile image
Yeo58

GP BS I think…..I was told this ages ago, long before covid. I checked if NICE guidelines had changed, they hadn’t, respiratory nurse at GP did not have a clue, I got referral to lung clinic at local hospital. As for suspension of spirometry due to covid, I think that was during the height of the pandemic, I had spirometry in 2022 and again this year. I’d argue it personally !

suzky123 profile image
suzky123

I live in nireland haven't had one hear since Feb 2020 nor a hospital appointment on oxygen for copd and ipf

JulyAugust profile image
JulyAugust

Hi, I had in-depth lung function tests and spirometry on new state of the art equipment at St George’s Hospital in Tooting, London in January 2023. The whole appointment lasted an hour…I had to blow so hard several times on different equipment, one was a cubicle that I had to sit in. I got the full results and a true reading (Fev1 43%). I don’t mind if I don’t have another for three years as I’m not sure all that puffing is actually detrimental. It certainly took every bit of breath I could muster.

Turnipgirl profile image
Turnipgirl in reply to JulyAugust

They're hard going aren't they those spirometry tests?

mlko profile image
mlko

Yes same problem here, A waste of time 20min just to fill in a questionnaire.

purdeyspringer profile image
purdeyspringer

Hi petercr, yes same here, since our Respiratory nurse retired my GP surgery stopped doing full tests, I now have to go to a chest clinic . But my gp do have a nurse that does basic check ups. Shortage of Respiratory nurses, and usual cut backs.

Slarty_Bartfast profile image
Slarty_Bartfast

There is no ban on spirometry and areas should be delivering these tests. This BMA article may be of use bmj.com/content/382/bmj.p2140

bravepat650 profile image
bravepat650

I have not had a spirometry test for 5 years . n was i .And not saw anyone in person for 5 years the last time i saw a nurse was in 2019 and they took my weight and height and told me i was over weight and was shrinking nothing about my copd.

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