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Virtual consultations, virtual wards and virtual pulmonary rehab have enabled continued safe patient – practitioner interaction during the COVID-19 pandemic and looks set to remain in place due to clear benefits in terms of protecting vulnerable patients from unnecessary infection or travel, keeping costs down, and convenience both to patient and clinician.

The Fit to Care document was initially developed to guide and support clinicians working with patients with respiratory disease. Since it’s first publication primary care has seen huge changes in the dynamics of the workforce providing this care. The document now applies equally to doctors, nurses, pharmacists, physiotherapists, paramedics and other allied healthcare professionals involved in the care of people with respiratory conditions. 

In this article we explore what healthcare policy is, why it matters, how we as healthcare professionals can influence UK healthcare policy and why we should. Carol Stonham is our immediate past Executive Chair and leads the PCRS Policy Forum. Dr Tracey Lonergan is the PCRS Policy Coordinator and a Medical Writer with a special interest in respiratory disease.

In early 2022, trained respiratory healthcare practitioner nurses in general practice were invited to participate in the South West Primary Care Respiratory Champions Project funded by the South West Respiratory Network. The programme offered structured respiratory education, networking and leadership skills. The programme was delivered by the respiratory network clinical leadership team. This article details the programme and outlines the project outputs and outcomes.

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. It is envisaged that NHS funding will increase to support systems to increase the capacity of community services, address waiting lists and expand models of care in the community to aid hospital discharges.

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. However, for many the focus has appeared to have been on protecting and improving secondary care – prompted by stories of 12 hour ambulance waits outside emergency departments and long surgery waiting lists. We asked two HCPs from across primary and secondary care to tell us about their experiences of transformation.

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. It is however important to understand where to look to understand strategic plans for respiratory, where future plans are made and at what level you might need to target, or find someone to listen to you, if you aspire to influence for better primary and community respiratory care.

The one-minute sit to stand test (1-MSTST) has become the test of choice during the pandemic for measuring exercise capacity, both at in-person and virtual appointments due to the inability to conduct robust six minute or incremental / endurance shuttle walk tests (6MWT/ ISWT/ ESWT). It can easily be conducted in the patient’s home or a small clinic room, requires little equipment, is quick to undertake and yields useful information about the patient’s physiological response to exercise.