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Spirometry testing is the most widely practiced, most common and adaptable of all lung function tests and spirometers are used as a key instrument in the diagnosis of patients with respiratory disease [1]. As a leading cause of death worldwide responsible for some 9.4 million deaths [2], and further increases predicted by 2020, the management of lung disease becomes even more dependent on spirometry testing. Yet evidence of widespread under-diagnosis [3] and, as a consequence, reduced quality of life and premature death [4] present cause for concern.The grim reality evident in the presented studies highlights a real lack of training [5], under-utilisation of spirometers [6] and diagnosis based on inaccurate results [7]. It is reported that chronic obstructive pulmonary disease (COPD), the most prevalent of the lung diseases, is under-diagnosed in 75% of cases [3]. The outcome of delayed diagnosis deters effective management and treatment, which ultimately aims to relieve symptoms, prevent disease progression, improve health status and prevent premature death [4]. While educational modalities were introduced at a national level to train spirometry practice in some European countries, a survey carried out by the European Respiratory Society (ERS) in 2008 confirms that no formal training in, assessment of, or qualification in spirometry takes place in many other countries. Using the HERMES project framework (Harmonised Education of Respiratory Medicine in European Specialties), a new Spirometry initiative aspires to train and qualify healthcare professionals best able to deliver high-quality spirometry. The potential benefits of standardised educational documents and training in the practice of spirometry are real and significant, strengthening patient care and improving quality of life for respiratory disease patients.Begun in 2005, the value of the HERMES initiative is that it …

HERMES Spirometry: the European Spirometry Driving Licence