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Welcome to the Summer 2021 edition of Primary Care Respiratory Update. In this publication, and in keeping with the weather outside, we are providing a focus on climate, Global Warming, and the environment. The balance of good and potential harm that comes with the delivery of respiratory care to our patients is a precarious one. It would be tempting to think of the solution in simple, even polarised terms- ‘this inhaler good, this bad’, but as you will see from the three superb pieces we are publishing here, the situation is much more complex than that.

This pragmatic guide has been developed based on the work of the PCRS Greener Healthcare Working Group. In 2020, the PCRS Greener Healthcare Initiative brought together respiratory healthcare professionals working in primary and secondary care setting, public health specialist, patient advocacy organisations, patient representative, policy influences, service users and decision makers as well as representatives from the pharmaceutical industry.

The necessary restrictions imposed by the COVID-19 pandemic have created a backlog of patients in primary care who have perhaps delayed coming forward with respiratory health concerns, whose respiratory condition has worsened during lockdown and those whose assessment or treatment has been delayed. As we emerge from this seismic shift in primary healthcare provision, there is an urgent need to work through this backlog of patients.

In this article authors Daryl Freeman and Noel Baxter discuss some top tips you can implement locally to make the case for and influence others positively in support of greener respiratory healthcare.

PCRS have issued a position statement on strategies to care for patients with respiratory disease and frailty in the community setting. Frailty is thought to affect around 10% of those aged over 65 years and up to half of those aged over 85 years. The health and social care needs of these vulnerable patients can be complex and require a holistic approach that should involve confirmation of current diagnoses and review of all medications giving consideration to the goals of treatment, likely benefits and likely side effects.

In this article Angela Wixey discusses a local programme of work that was established to unravel the risk factors associated with under- and over- diagnosis of COPD.   The service was operated by a Respiratory Nurse Specialist (RNS) credited by the Association of Respiratory Technology and Physiology (ARTP) in spirometry who examined 375 patients in five practices across the county over 9 months.

In association with Sandoz, we are delighted to be hosting this webinar series on asthma care The Journey Begins with the Right Diagnosis

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.