Given the direct impact of COVID-19 on those with existing breathing difficulties, the ‘newly breathless’ – those whose lung function has been impaired by Covid – as well as rising levels of air pollution, the need for social prescribing solutions in respiratory healthcare has never been greater.

The transformation of out of hospital services has been identified as a key element of the NHS recovery plan. Patient care delivered closer to or in their own homes was identified as a priority in the NHS Long Term Plan.

The formation of Integrated Care Systems in July 2022 has given us as healthcare professionals an opportunity to improve and shape respiratory care in our area for patients with respiratory disease.

It can be a challenge to keep up with the rapid changes in how the NHS is governed and organised across all the nations of the UK.

Non-tuberculous mycobacteria (NTM) are a group of bacteria that are capable of causing opportunistic lung infections and the development of NTM pulmonary disease (NTM-PD).

In this article we review the major changes in the 2023 GOLD report as they impact on the initial and ongoing pharmacological management of COPD and consider the implications for primary care in the UK.

This pragmatic guide on the identification, referral and ongoing management of adults and children with severe asthma has been developed by an expert group led by Dr Steve Holmes, a GP based in Shepton Mallet, Somerset and including Will Carroll, University Hospital of the North Midlands, Stoke-o

This issue of PCRU introduces our latest pragmatic guide on severe asthma which guides you through this process ensuring the right patients end up in the right place with the right care.

Historically, clinical decision rules have been used to guide antibiotic prescribing for patients presenting with signs and symptoms that indicate possible RTIs or infectious exacerbations of chronic obstructive pulmonary disease (IE-COPD).

Our intention is for the upper airways to be considered in tandem with the lower airways to avoid misdiagnosis and undermanagement. Implications for diagnosis and treatment are discussed and an algorithm offered.

Can Only Plan Daily - COPD is a serious disease needing the right diagnosis and treatment with the person’s need sitting front and centre.

This edition of PCRU has a flavour of 'out with the old and in with the new', as it is the last one in which we will feature Noel Baxter's thoughts and reflections from the Chair.

Key learning points: • Taking a history, doing the examination, chest X-ray and spirometry are really important • Look for red flags and refer these patients straight to secondary care. • Do the basics which will point you towards the things you can do in primary care.

Asthma Guidelines in Practice – A PCRS Consensus is a practical and pragmatic guide for healthcare professionals working in primary and intermediate care.  This guide was commissioned to provide clarity on aspects of diagnosis, management and monitoring of asthma that are uncertain

This 'Get Winter Wrapped' issue focuses on the twin challenges of winter pressures and coping with COVID-19.