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Part of our Digital Technology Webinar Series 2022, exploring the ethics and inequalities of digital technology  

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). Use of point of care testing (POCT) for C-reactive protein (CRP) addresses clinical uncertainty to support not prescribing antibiotics in appropriate low-risk patients. This approach has been shown to reduce unnecessary antibiotic use and is therefore an important tool in ensuring antibiotics are used appropriately.

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. Both the original document and this summary have been produced as a consensus document based on a working group comprising PCRS members

Dr Steve Holmes - Somerset: A Whole Practice Approach to Greener Healthcare This case study from Dr Steve Holmes provides an overview of the changes he and his colleagues have made over the past twenty years in order to improve not just the practice they run and how it operates, but also play its part in helping to maintain and improve the wider community that it is based in.

Can Only Plan Daily - COPD is a serious disease needing the right diagnosis and treatment with the person’s need sitting front and centre. ‘All that glitters is not GOLD, nor is it even NICE’ is a consensus-based article that sets out a simple treatment pathway based on the predominant characteristics of COPD for an individual – whether symptoms or exacerbations – distilled from current guidelines.

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. His successor, Carol Stonham, is fast off the mark though with her superb and clinically invaluable consensus article on the use of fractional exhaled nitric oxide (FeNO) in clinical practice.

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. • If you are worried about patients at any stage or feel you haven’t got a clue – you can refer them to secondary care at any stage

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 due to differences between current national UK guidelines.

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