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.

Vikki Knowles - Surrey: Minimising MDIs Independent Respiratory Nurse Specialist Vikki Knowles shares the early stages of work being done to minimise the use of Metered Dose Inhalers (MDIs) in their practice in Surrey and how that can positively impact the greener healthcare environment

Dr Kat Parker - Bristol: Switching to DPIs In this case study from Dr Kat Parker, she shares her experience of how her practice in Bristol has been switching patients from Metered Dose Inhalers (MDIs) to Dry Powder Inhalers (DPIs) where appropriate to do so, when and how they communicat

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 als

Jane Scullion and Dr Steve Holmes return to discuss the topic of shielding and whether its legacy has been predictable and the longer term impact of deconditioning on respiratory health.

In this short episode Jane Scullion and Dr Steve Holmes discuss the use of rescue packs in asthma and COPD.  They challenge current views and perceptions on the use of rescue packs and explore the evidence around their use.