There are many ways and circumstances in which patients may present to a healthcare professional and be diagnosed with COPD. It may be to a primary care service (pharmacy, nurse or general practitioner) because of experiencing increasing breathlessness, an attack of bronchitis or the patient might be attending a routine flu vaccination or health screening. It is also possible that they are attending an outpatient (general or specialist) or follow-up clinic after a hospital admission. Each of these circumstances is a little different and requires a sensitive hand to ask the correct questions and guide the patient through the process of clinical diagnosis, appropriate testing, initiation of treatment and counselling on prognosis.