Providing nursing care for people with chronic respiratory disease in the context of multiple long-term conditions.

<bold>Background:</bold> Chronic disease is a major healthcare challenge. In the United Kingdom (UK), primary care nurses predominantly deliver chronic disease support. Nurses are trained in condition-specific care and may find caring for people with multiple long-term conditions (MLTCs) challenging. <bold>Methods:</bold> Interviews with primary care physicians, nurses, administrators and people with lived experience of MLTCs from sixteen general practices in three UK areas. <bold>Findings:</bold> UK primary care nurses generally deliver condition-specific care to people with chronic respiratory and other chronic diseases. Some nurses were uncomfortable delivering care to people with MLTC, believing it might necessitate practising outside their sphere of competence. Some employers recognised the importance of MLTC nurse training and facilitated this, others did not. Volume of patient demand for primary care, compounded by operational pressures such as staff shortages, meant releasing nurses for training was difficult. Despite initial concerns, nurses reported increased job satisfaction when delivering holistic, person-centred MLTC, rather than condition-specific, care. Some patients valued specialist knowledge of chronic respiratory disease, regular contact with primary care and relational continuity with condition-specific nurses. Other patients prioritised immediacy of access to primary care over relational continuity, valued fewer visits and appreciated a holistic approach, considering all their conditions. <bold>Conclusion:</bold> Consideration should be given to training nurses in primary care to provide MLTC in addition to condition-specific care.