Improving the quality of diagnostic spirometry in adults:

1. Improving the quality of diagnostic spirometry in adults: The National Register of certified professionals and operators

2. Assessing and certifying competence in performing and/or interpreting diagnostic spirometry • Background • The framework: • Competency Levels • The National Register • Routes to certification • Certification & Re-certification • Training • Timetable for implementation

3. Background • 2013: A Guide to Performing Quality Assured Diagnostic Spirometry – initial work on standards • 2014: All Party Parliamentary Group (APPG) Report on inquiry into Respiratory Deaths (2014) calls for a system to assess and certify the competence of all healthcare professionals undertaking and/or interpreting diagnostic spirometry • 2016: competency assessment framework launched

4. 3 Competency Levels • Foundation: competent to perform safe, accurate and reliable spirometry tests without interpretation • Full: competent to perform and interpret spirometry in terms of physiological changes • Interpretation Only: competent in interpretation only (no responsibility/ requirement to perform spirometry but required to interpret the results of spirometry accurately )

5. The National Register • Single national register maintained by ARTP as the certifying body • Lists individuals’ names according to whichever of three categories of certification that person has achieved: Foundation, Full or Interpretation Only • Indicates the date when certification was obtained

6. I interpret the results of spirometry tests performed by others I perform spirometry tests without interpreting the results I have performed spirometry with / without interpretation for many years and consider myself competent I perform spirometry tests and interpret the results Undertake appropriate training Experienced Practitioner Scheme Assessment by ARTP approved assessor Successful completion = certificate of competence Enter certificate of competence in relevant category on The National Register KEY Training needed No training Training need identified following EPS assessment

7. Certification & Re-certification • Once certified, healthcare professionals must record their qualification on the National Register • Certification is valid for 3 years, after which re-assessment is required to remain registered as competent to practice • Further training is NOT mandatory to re-recertify • Refresher training courses are available • Further information on re-certification is at http://www.artp.org.uk/en/spirometry/reaccreditation.cfm

8. Experienced Practitioner Scheme (EPS) Initial certification Re-certification Individuals performing spirometry with or without interpretation, not on The National Register Inexperienced individuals not on The National Register Individuals already on The National Register • Undertake training and assessment appropriate to level • Successful completion = certificate of competence • Undertake assessment appropriate to level • Successful completion = certificate of competence • Unsuccessful = need to improve skills prior to reassessment • Remain on The National Register for • 3 years then • undertake re- • certification process The National Register with re-assessment of competence every 3 years

9. Timetable • Implementation phased over four years 1 April 2017 – 31 March 2021 • Healthcare professionals currently performing and interpreting spirometry will have until 31 March 2021 to be assessed and entered on to the National Register • Document is available at https://www.pcc-cic.org.uk/article/quality-assured-diagnostic-spirometry