Spirometry is increasingly used in primary care settings for the diagnosis and monitoring of patients with respiratory conditions. Conducting and interpreting the test is now part of many practice nurses' role. Spirometry is, however, effort dependent and the validity of a test result relies on the patient being able to master the technique. The role of the practitioner conducting the test - instructing, supporting and encouraging the patient - is vital. Adequate and appropriate training is essential to ensure that spirometry is properly conducted and any errors in technique identified and corrected.

Heart failure is the leading cause of hospitalisations in the over 65s and has a high prevalence in patients attending for regular review of long term illnesses such as diabetes, hypertension and chronic kidney disease (CKD). General practice nurses play a vital role in the management of patients with long term conditions, and are therefore in an ideal position to identify the early signs and symptoms of heart failure in patients that are most at risk of developing this condition.