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Air pollution causes up to 36,000 deaths in the UK every year and both cause and worsen lung disease. While outdoor air pollution may be a topic for governmental policy, we, as healthcare professionals, can take a range of steps to minimise our own contribution to local levels of air pollution, improve the air quality in our places of work and support patients in managing their risk from air pollution in their daily lives.

Point-of-care testing of C-reactive protein (CRP) for the acute assessment of worsening symptoms in people known to have COPD can safely reduce the use of antibiotics and could help improve the diagnostic approach towards someone presenting in such a crisis. New high-quality evidence has emerged since the last NICE COPD update and we encourage re-opening and review of the current guideline to enable clinicians and system leaders to understand whether and how to implement this promising diagnostic aid.

In this article we discuss how to incorporate environmental considerations when selecting inhaler devices for patients newly diagnosed with respiratory disease. We also consider how to safely change to inhalers with a lower environmental burden when clinically appropriate and how to support patients in making the decision to change.  

As of April 2021, regional health and care needs in England will be coordinated through Integrated Care Systems (ICSs) (https://www.england.nhs.uk/integratedcare/what-is-integrated-care/).

This Abstract was presented at Pharmacology 2020, 14–18 December.

Although the virus has been devastating for so many, it has also accelerated development and adoption of technology across many areas of the healthcare system. It has also highlighted challenges and opportunities as we move into a post-pandemic world.

Noel Baxter PCRS Policy Lead and Tracey Lonergan PCRS Policy Coordinator.

Clare Cook Physiotherapist, Clinical Lead of a community respiratory team in Bristol, member of PCRS Executive Committee and Chair of the PCRS Respiratory Leadership Group in conversation with Dr Elaine Bevan-Smith Associate COPD Specialist South West of England Academic Health Science Network and founder of the Breathe happy groups.

Pulmonary rehabilitation (PR) has been included as a key intervention in the NHS Long Term Plan. However the PR audit1 showed that only 62% of people referred go on to complete the course. Moreover, the greatest attrition in the referral process occurs between referral to first contact with PR.