Primary care - your GP and practice nurses

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Different healthcare professionals have different expertise and roles.  GPs and practice nurses are generalists - they have to know about lots of different health conditions.  Some specialise in particular conditions, such as COPD or Asthma

Information about when you should go to your GP

If you do not have a history of any respiratory problems like asthma or COPD, you should contact your GP if you have a new cough or a substantial change in the nature of your cough which has lasted for 3 weeks or longer. It is important to do this urgently if you notice blood when you cough, if you have unexpectedly lost weight, or if you feel poorly.

You should also speak to your GP if you have shortness of breath which you feel is unusual, or which limits your ability to perform physical activities such as exercise or housework. You should contact your GP urgently if you feel that your breathlessness is severe, or if you are having difficulty with speaking.  Your GP would also wish to know if you suffer from wheeze or pain or tightness in the chest when you breathe.

If you do have a history of respiratory illness, then you should contact your GP if you feel that your condition has become significantly worse. This could mean that you need extra medication like inhalers or tablets (for instance, antibiotics or steroid tablets).
  • It is best to contact your GP practice in the morning time, so that the practice can assess your symptoms in a timely manner, and so that if you need a prescription, you will be able to find a pharmacy that is open to give you your medication.
  • It is OK to call your practice in the afternoon if your symptoms come on quickly or get rapidly worse and you feel that they cannot wait until the morning.

In the evenings and at weekends, if your symptoms are very concerning to you and you feel you need emergency treatment while your practice is closed, then you can call the Out of Hours medical team on 111. 


What to expect when you contact your GP practice

When you contact your GP practice about your symptoms, you may be given an appointment with a doctor, or with one of the other members of the practice team, such as a nurse with advanced qualifications. It is OK to ask who you are speaking to, and whether they are the right person to help you with your symptoms.

Your first appointment may be in person, or it may be on the telephone or on a video call. If it is on the phone or a video call, then a further appointment for a physical examination may be made later on if you and the practice agree that this would be beneficial. Every GP practice works in slightly different ways, but all will work with you to provide the appropriate care for you.

Smoking
Your GP or nurse will ask you whether or not you have ever smoked. If you smoke currently, you will be offered advice about this, and guidance about how to stop. We know that some people find this conversation difficult, but your GP or nurse should try and communicate with you in a way that you find comfortable. 

Your GP or nurse is not making judgements about you or telling you off when they ask you about smoking. There are many different treatments available on prescription that can help you to stop smoking, and a variety of professionals who can support you while you do so. Stopping smoking is the most important thing you can do to improve most respiratory conditions.

Symptoms

During your appointment with your GP or nurse, they will ask you several questions about your symptoms and how they affect you, and they may examine you. You will also have an opportunity to ask questions of your own. You could be given a diagnosis (this means you are told what is causing your symptoms), or possibly you may be offered reassurance and advice. 

Often, your GP or nurse will need to speak to you on more than one occasion to make the assessment. They may want to arrange some tests, or they may wish to wait and see how your symptoms change over time.

Examples of tests that may be considered are chest x-rays, blood tests, and tests that involve you blowing, such as peak flow tests or spirometry. Your GP or nurse will explain to you why they think you need the tests, and what the tests involve. They may also consider whether you need to speak to a specialist doctor or nurse. They will advise you why they feel that that is important, and how the referral is made. Not everybody who has problems with their breathing or a cough needs to have tests or to see a specialist.

Medication
If you are given a diagnosis such as asthma or COPD, you may be offered medication, though medication is not always needed.

Sometimes medication is given by inhalers, and sometimes in tablets or liquid medicines. Very rarely medicines may also be offered in other ways such as injections, but you will always be told what the medications are for and you will be given opportunities to ask questions about them.

You may be offered a personal management plan that describes what you should do if your symptoms get worse. Some patients are offered "Rescue Medications" like antibiotics and steroids, to keep at home and to take when their symptoms get worse. If you are offered these medications, you will be given clear advice about how you will know when to take them, and about letting your practice know that you have done so. 

Advice
You could also be given advice about:
  • Other things you can do to help your symptoms, such as a healthy lifestyle and exercise.
  • Other sources of support through organisations such as Chest Heart & Stroke Scotland (CHSS) and LGOWIT

Find out more in the My Wellbeing and My Wider Support Network areas of this resource hub.

What happens after you have been given a respiratory diagnosis

It is important that people with respiratory illnesses are offered advice about follow-up care.  Typically, once patients have their symptoms stabilised they are reviewed once a year, but sometimes they will be asked to come back sooner, for instance if the diagnosis is new, if they have had a recent medication change or their symptoms have been very troublesome.

Usually, follow-up care is provided by GP practice nurses, but sometimes patients may need to have ongoing care from specialist nurses or their GP.  The person who is most involved with your care (for example, your GP, nurse or specialist) will advise you on the most appropriate follow-up care in your particular circumstances. You may be offered a personal management plan that describes what you should do if your symptoms get worse. You may also receive advice about vaccinations against illnesses like flu. 

Information from other sources

What to ask your doctor - NHS UK

Annual medical review - My lungs, my life

 

Please go to our brief feedback survey to tell us what you think about the Respiratory Resource Hub.  We would particularly like to know if you think any information is missing, or there are other topics you would like the resource hub to cover.