The strategy, which was launched last week and also covers asthma care, focuses on improving early identification and self-management.

The DoH says that around three million people have COPD but that fewer than one million have been diagnosed.

It suggests screening ex-smokers over 40, patients with previous pulmonary TB or first-degree relatives of those with COPD to find the two million undiagnosed cases. Pilot studies will establish the best way of selecting groups for screening.

Specific targeting will lead to an earlier diagnosis of those with mild or moderate COPD, the DoH says. It suggests conducting spirometry in at-risk children from the age of seven.

QOF indicators for pulmonary rehabilitation and pulse oximetry are also proposed and these have been suggested to NICE's QOF review committee.

The final strategy will use the new definitions of disease severity being developed by NICE, rather than the current GOLD definitions.

Sheringham GP Dr Daryl Freeman, respiratory GP specialist for Norfolk, said there were 'huge opportunities' to identify undiagnosed COPD patients during other consultations, such as vascular checks.

Patchy services around the country suggested that some PCTs could improve care by reprioritising without needing to increase funding, she said.

Somerset GP Dr Steve Holmes, education lead for the Primary Care Respiratory Society UK, said the strategy should be seen as setting out long-term goals.

'The strategy is aspirational, in terms of how we move forward in the next five to 10 years, rather than something to achieve in the next few months,' he said.

Dr Holmes said that studies into the effectiveness of early identification schemes would prevent GPs wasting time using ineffective screening methods.

COPD strategy
Two million undiagnosed COPD patients to be identified by screening. New QOF indicators. Revised guidance to match NICE advice. Comments on the strategy can be made via the DoH website until 5 April.