Inspiringbestpracticeinrespiratorycare
Summaryofvisualidentityelementsandsampleapplications
Draft 12th July2018
PCRSBrandGuidelines
Inspiringbestpracticeinrespiratorycare
TheNewPCRSLogo
● Thenewlogoisarepresentationofwholepersonrespiratorycarewithapositiveelementofcommunityatitsheart.
● ThenewnamefortheorganisationisPCRS,renderedwithoutthe‘UK’now,exceptforinthedomainnameandinlegalcircumstances.
● Thetwooptionsshownillustratethelogoonawhitebackgroundandwithawhitemargin.Thisistobeusedwherestandoutagainstacolourbackgroundisneeded.Thelogoshouldneverbeusedoverimagery,orwithdropshadowsoronbackgroundcoloursoutsidethoseoftheprescribedpalette.
● Thereisaclearspaceareatobeobservedandaminimumsizeofnomorethan1cmsqonline.
MasterLogoonWhite MasterLogoAgainstColour
MonoLogoinBlack MonoLogoinMonoGrey1
MinimumClearSpace
MinimumSize/Favicon
Inspiringbestpracticeinrespiratorycare
Typography
● We’vedevelopedatypographictoolkitforPCRSofcomplimentaryfontsthatworkacrossallmedia.
● ThelogotypefontforPCRSisAveriaSerifLibre.ThisisacontemporaryseriffontthatconfersmodernityandgravitasequallytothePCRSbrand.Itisonlytobeusedwithinthelogo.
● TheHeadlinefontforallmaterialsisAvenirMediumandHeavyasthestrongerweightforemphasis.
● TheBodycopyfontforallmaterialsisHelveticaNeueLightforPCRUandMediumandBoldasthestrongerweightsonlineandforemphasis.
● ThedefaultfontforemailsandslidematerialsisCalibri.
● Fontuseshouldbekeptsimple.Avoiditalicsandallcaps.Usedifferentsizesandweightstocreateeffectivetypographyandnavigationofread.
PCRS Inspiring best practice in respiratory careThe Primary Care Respiratory Society
PCRS ThePCRSlogotypeismadeallthemoredistinctivebyusingafontwhichhascharacter.WhilethisfontispartofPCRS’svisualidentityitisonlytobeusedwithinthelogotypeitself.
WhenthePCRSstraplineappearsalongsidethelogotype,AvenirHeavyandMedium,whichisthePCRSHeadlinefont,areusedincombination.Thiscreatesaclean,effectivestraplineusingdifferentpointsizes.
Avenir Heavy Avenir Medium
Averia Serif Libre
Helvetica Neue Medium Helvetica Neue Regular
ThesetwoweightsofHelveticaNeueindifferentpointsizes’alongwithAvenirastheHeadlinefont,arecapableofcreatingatypographichierarchyandallthedifferentiationofreadthatisnecessarytomakelargeamountsofbodycopyeasytoread.NeveruseALLCAPS-thisistheequivalentofshouting.Avoidtheuseofitalicswhereverpossible.Initialcapitalsshouldbeusedintitlesexceptforadverbs/conjunctivewordslike‘to’or‘and’whichshouldremaininlowercase.Toemphasistext,useaheavierweightoradifferentsizeweightifyouarestackingtext,asshowninthestraplineexampleabove.
CalibriCalibriisthedefaultfontforinternaldocumentsandemails.Itisastandardfontthatcanworkacrossallemailoperatingsystems.CalibriisnotbetousedasasubstituteforAvenirandHelveticaNeueonanyonlinematerialsordocumentationotherthanintheseinstances.Aswiththeotherfonts,usedifferentweightsorpointsizesforemphasis.Avoidhighlightingtextinothercoloursandkeeptypographicvariationstoaminimum-twoweightsplustwodifferentpointsizesideallyatmost.
Helvetica Neue Light
Inspiringbestpracticeinrespiratorycare
ColourPalette
● WehavedevelopedandextendedthePCRScolourpalettesoitcanbeusedasacorevisualidentityelementacrossdigitalcommunicationsforPCRU,internallye.g.forslidedecksandforchartsanddatagraphics.
● Thenewcolourpalettehasbeendesignedasacolourspectruminwhichallcoloursbalanceoneanother.
● Colourisasignpostingtoolthatlendsvibrancytothebrand.
● Inkeepingwithonlinedesignprinciples,thesecoloursmustalwaysbeusedflat.Theyshouldnotbeusedasgraduations,withdropshadowsorusedwithothervisualembellishments.
● Iftintsarerequired,50%or25%ofoneoftheoriginalcoloursshouldbeused,asshownhere.
50%tintpalette
25%tintpalette
Monopalette
DarkBlue PCRSBlue NavyBlue PCRUBlue MidBlue LightBlue LightAqua
Teal Turquoise LimeGreen Olive Tan Orange Straw
#06253E #003A56 #153B64 #0C4C83 #597F9B #8EBCD5 #96CFD8
#38727C #589392 #BAC154 #819239 #CB822C #EB7D23 #F2C24B
Black Mono1 Mono2 Mono3#000000 #232323 #7A7A7A #B5B5B5
Inspiringbestpracticeinrespiratorycare
ColourChart
Old Colour Palette (Black Hole Branding)
PCRS core colour #003A56
Local Nurse Group Core colour #00babe
Local Nurse Group Secondary Colour #94d6da
Local Nurse Group Core colour #00babe
Local Nurse Group Secondary Colour #94d6da
Respiratory Leaders Group Core colour #0e4e96
Respiratory Leaders Group Secondary Colour #00c0f3
Practice Membership Core colour #76b043
Practice Membership Secondary Colour #bdd753
EConnect Membership Core colour #f6891f
EConnect Membership Secondary Colour #ffce34
● ThiscolourchartshowstheRGB,CMYKandHexcodesforeachofthecolours,togetherwithnotesonhowtheyareusedacrosscommunicationsmaterials.
Inspiringbestpracticeinrespiratorycare
Shapes
● Combinationofshapesandcolourstogetherareapowerfulvisualidentityelement.ForPCRS,we'reusingsimpleshapescombinedwithflatcoloursthroughoutandforchartsandgraphs.
● Shapesshouldeitherbeasolidcolourorhaveasimplekeylineofaminimalpointwidthwithaclearbackground.
● Shapescancontaineithersquareedgesorroundedcorners.
● Dropshadows,blurredshapesandotherembellishmentsshouldbeavoided.Thefocusissimple,assuredandcleandesign.
● Textcoloursshouldbeblackorwhite,orcorecoloursasappropriate.Avoidusinghighlights,italics,allcapsorotherdecorativedevices.
● Avoidallcomplicatedshapes,sticktosimpleformstocreateaboldimpression.Usewhitespacetokeepdesignsclean.
Inspiringbestpracticeinrespiratorycare
SecondaryNavigationandImagery
● ThenewPCRScolourpaletteisusedtocreateabalancedvisualsignpostingsystemonlineinsecondarynavigation.
● ThesesixbuttonshighlightcoreareasofPCRSactivity,blendingcomplimentaryimageryandflatcolourtogether.
● AlltheimageryusedhereisroyaltyfreebutmustbecreditedonPCRSWebsiteTermsandConditionspage.
● Ifimageryisused,itshouldbeusedincombinationwithflatcolourshapes,astheyarehere.
● Avoidoverlayingtextontoimagery.
● Donotusecut-outsorunusualshapes.Instead,useimagerysimplyonitsown,withathinkeylineorasashapewithcolourasthesegraphicsshow.Donotuseimagesasbackgrounds.
ClinicalLeadershipImage PhotobyrawpixelonUnsplash https://unsplash.com/photos/w9YHKTK-wLo
AffiliatedGroupsImagePictureSourceoffice-1209640_1920.jpg
PCRUImagePictureCreditVisceralBusiness
AnnualConferenceImagePhotobyrawpixelonUnsplashrawpixel-310778-unsplashv2.jpg
MembersDirectoryImagePicturebyJonTysononUnsplashjon-tyson-520972-unsplash.jpg
ProfessionalDevelopmentImage PhotobyrawpixelonUnsplash rawpixel-602153-unsplash.jpg
Clinical Leadership
Affiliated Groups
Annual Confe rence
Members Di rectory
Professional Development
Inspiringbestpracticeinrespiratorycare
SupportingGraphics
● ThecorePCRSgraphicsofthelungandstethoscopehavebeenredrawn.Theycanbeused,wherenecessary,forvisualrelief.
● Keepallgraphicsclearandsimpleinlinewiththeprinciplesofthenewbrand.Aswithhospitalsignage,clarityandconsistencyhavemoreusefulnessinwayfindingthanavarietyofgraphics.
● Aswithsecondarynavigation,imagerycombinedwithflatcolourcanbeused.ThePCRSlogomustnotbeplacedontopofanyimagery,butitcanbeplacedontopofflatcolour.
● Buttonshapesworkbestwhentheyareflatrectangles,notrounded.
PCRS Committee Email
Primary Care Respiratory SocietyInspiring best practice in respiratory care
The Primary Care Respiratory SocietyInspiring best practice in respiratory care
Your helpful primary resource for all your respiratory care needs Find us at www.pcrs-uk.org
Respiratory Leaders Programme
Coming Soon!
Local Nurse Groups
OldGraphics
NewGraphics
Primary Care Respiratory SocietyInspiring best practice in respiratory care
PCRS Email
Inspiringbestpracticeinrespiratorycare
CopyandToneofVoiceGuidelines
TheaimofPCRScopyandtoneofvoiceguidelinescanbesummedupinonesentence-Conveycontemporaryauthorityinahumanway.
Overall,PCRS’toneofvoiceshouldbeassured,confidentandposiJve.
Contemporaryauthorityisaboutbeingrelaxed,notbeingformalorstuffy.WriinginahumanwaymeansPCRScommunicatesasfriendlyadvisors.
Weshouldneverpatronisingreader,use‘adulttochild’language,ormakeassumpionsaboutwhatreaders’need.Beaccessible,andnotclosedtodiscussion.
WewantallPCRScontenttobewrijensothatitisregardedasusefulandposiJve.Thedesiredresponsefromreadingcontentisitwillreinforcepeople’spercepionthatPCRSprovidesvaluableinformaion,theyenjoybeingpartofPCRSasasocietyandmembernetworkandpotenialmembersandotherstakeholderswillbeajractedtoPCRSasanorganisaiontheycanengagewith.
ThePCRSName
PCRShasagreedtochangethewayitsnameisrenderedtoPCRS,insteadofPCRS-UK,inallcases.Theonlyareaswherethisdoesnotapplyarethewebsiteurlwhichispre-determinedandinlegalinformaionwherethelistedcompanynameistobeused.
WriJngStyle
CopystyleisacoreelementofcontentmanagementanditplaysanextremelyimportantandpersuasiveelementwithinPCRSbrandcommunicaionThereareafewprinciplestobearinmindwhenwriingcopythatwillhelptocreatetheassociaionswewantreaderstohave.
KeepitBrief
Goodwriingcutsoutanythingnotnecessarytoconveythepoint.Lessismore,leanandeffecivecopywriingissomethingyourreaderswillappreciate,soconsiderwhatneedstobeinaheadlineandfindeconomicwaystocommunicateinformaionhoweveryoucan.
Forexample,headlinesshouldbesuccinct.Itmakesthemeasytorememberandsearchable.Inthecaseofthisheadline–‘IsyourpracicereadyforPulmonaryRehabilitaionWeek16-24thJune?’Thedatedoesn’tneedtobeintheheadline.Aninterestedreaderwilllookattheariclewheredetailedinformaioncanbepresentedasawhole.
TalktotheReader
Writeasifyouaretalkingtothereader,notmakingannouncementsasanimpersonalorganisaion.ThiswillhelppeopleengagewithPCRSanddevelopcontentappeal.
BeImmediatelyHelpful
Framearicleandemailheadingsusefully.Posingchallengingquesionsmayhavea‘yes/no’answerandclosedownacion.Offerusefuladvice‘Howtogetreadyfor’,forexample,andsignpostittoo,e.g.‘Newinformaionabout…’
Goingbacktoourearlierheadlineexample,‘IsyourpracicereadyforPulmonaryRehabilitaionWeek16-24thJune?’thisisaquesionthatprompts‘yes/no’answersinthemindofthereader.Instead,beimmediatelyhelpfulbyframingtheheadlineasusefulinformaion‘HowtoGetYourPraciceReadyforPulmonaryRehabilitaionWeek’,asanalternaive.Considerlessofafearmongeringelementwithinthetoneofvoicei.e.‘therearejusttwodaysleosoactnowtosecureyourplace’simplyinbold.
AvoidJargonOverload
Clinicalinformaioniscomplexandprecise.MakinglightworkofcomplicatedinformaioniswherePCRScanbemostusefulandbeseenasavalued‘goto’desinaionforprofessionaladvice.Consideruseoftextandterminology,referencingitbutnotrelyingonitattheexpenseofbeinghuman.Makeitaccessibleandapproachableforthereaderasmuchasyoucan.
StreamlinePunctuaJonAsMuchAsPossible
Deletecolonsandavoidallcaps.Instead,useiniialcaps.Exclamaionswork,butonlyinsmalldoses.Theyshouldbeusedsparingly.Eitherthewordscandothejob,oranexclamaionpointwill,butnotboth,andnotooen.
Inspiringbestpracticeinrespiratorycare
Gridsandformats
● Gridsmaintainconsistencyandbuildupacoherentpresentationstyle.Alwaysuseagridtodesigninformation
● Textshouldbealignedandrangedleftasadefault.Avoidcenteringtext.
● Bulletpointsshouldbeusedat75%sizetotextweight.TheycanbeusedinvariousprescribedcoloursbuttryandkeeptoPCRUBlueasshownhere.
● Donotuseanyotherbulletpointgraphicsstyles.Donotuseanybackgroundwallpapersorgraphics
● Alwayssegmentslidetemplatepageswithanappropriateheaderareaandfooterasshownhere.
● Thistemplateandthepagesoverleafshowsomeexampleapplicationsthatareareferenceforhowtodevelopgridsandformats.
Clinical Leadership
Inspiringbestpracticeinrespiratorycare
Examplelayout
• Brandreview
-ShowedPCRStobeperformingwellbut(alongsidewebsitemappingandreviewof analytics)reinforcedwecoulddomuchbetter.-Highlighted‘issue’withourname.
• InputfromPCRSExecutivetoguidedevelopmentofcreativebrief-Moreconfident,innovative,dynamic,forwardthinkingwhilstretainingpeoplefocus.
• CreativebriefagreedwithCS/NBplusPMB&AJS
• Threecreativeroutesexplored -Typographical-Human-Leadershipinrespiratorycare
Clinical Leadership
Inspiringbestpracticeinrespiratorycare
Tablesexample
Clinical LeadershipDelegaterecruitment-registrations
Event 2018 2017 2016 Notes
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Inspiringbestpracticeinrespiratorycare
Applications
Clinical Leadership
Inspiringbestpracticeinrespiratorycare
Website-HomePageDesign
Clinical LeadershipBefore After
Thebackgrounddesignshownhereisoneoption,dependingofhowpagedesignswillbedevelopedonatestsite.Thebluecolourbackgroundhelpsthecontentpagedesignitselftostandout.Tomakeanyfinaldecisionsthesedesignsneedtoberenderedandviewedonvariousdevices.WerecommendroundelbuttonstocomplimentthePCRSlogo.
Inspiringbestpracticeinrespiratorycare
Website-BasicNodePageDesign
Clinical LeadershipBefore After
Inspiringbestpracticeinrespiratorycare
Website-NewsNodePageDesign
Clinical LeadershipBefore After
Theactivepagelinkishighlightedinorangesopeopleknowwheretheyare.
Thisalsoapplies,ifpossibletotheurlthreadshownwheneachpageisloaded.
Asign-uplinktoInTouchhasbeenincluded.
Inspiringbestpracticeinrespiratorycare
Website-CommitteePageDesign
Clinical LeadershipBefore After
Inspiring best practice in respiratory carePCRS
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Management of ch ild ren and y oun gpe opl e ( CYP) with ast hm a: A clinica laudit report.. .20th Ju ne- 12:0 0pm
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Point of ca re mic rospir ometry tofacilitate the COPD diagnosticpr ocess in primary ca re...22nd May 2018 - 12:00am
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PCRS (The Primary Care Respiratory Society is a registered charity (Charity No 1098117) and a company limitedby guarantee registered in England (Company No 4298947) VAT Registration No 866 1543 09.
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Inspi rin g best practi ce in respiratory carePCRSThe Primary Care Respiratory Society
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Resou rces / Treatment Guidelines COPD Going for GOLD
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Tr eatment guidelines for COPD - Going for GOLD?’ is a consensus based article, that sets out a simple treatmentpathway based on the predominant characteristics of COPD for an individual - whether symptoms or exacerbations- distilled from curr ent guidelines. The article has been developed by a group of clinicians working with and in primary care, facilitated by integrated care consultant, Vince Mak, GPs, Duncan Keeley and Kevin Gruffydd Jones and practice nurse, Carol Stonham
Gold article only_REV_March2018.pdfAuthor(s): Vince Mak, Kevin Gruffydd-Jones, Duncan Keeley, Car ol StonhamClinical Area: COPDListing Status: Curr entDerivation: PCRS Produced / PCRS CollaborationCategory: Clinical resource or information
Management of children and youngpeop le (CYP) with as thma: A clin icalaudit report...20th June- 12:00pm
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Point of care microspirometry tofacilitate the COPD diagnosticprocess in primary care...22nd May 2018 - 12:00am
Inspiringbestpracticeinrespiratorycare
PCRU-Cover
Clinical LeadershipBefore After Option 1 After Option 2
www.pcrs-uk.orgPrimary Care Respiratory Society
Spring 2018Issue 14
PCRS
Edition Highlights
Asthma Guidelines in Practice
Respiratory tract infectionsand antibiotic prescribing
Appropriate use of rescuepacks
Stepping down ICS in COPD
Primary Care Respiratory Update Primary Care Respiratory Update
www.pcrs-uk.orgPrimary Care Respiratory Society
PCRS
Edition Highlights
Asthma Guidelines in Practice
Respiratory tract infectionsand antibiotic prescribing
Appropriate use of rescuepacks
Stepping down ICS in COPD
Spring 2018Issue 14
PCRSbrandingismoreovertandplacedwheretherewillbegreateralignmentwithlayoutfordigitaleditions.TheEditionnumberingsystemhasbeenadaptedtoalignwithdigitaldownloads.PCRUBlueisbeingusedforthecoverandinternallysothereismorecongruencewithothermaterialse.g.slidedecks.Thetwocoverlayoutoptionscreatetheopportunitytovarythelayoutofimagerywhilstinkeepingwiththeoveralldesign.
Inspiringbestpracticeinrespiratorycare
Primary Care Respiratory Update
Find us online at www.pcru-uk.org/pcru
The Primary Care Respiratory Update is publishedquarterly and distributed to members of the PrimaryCare Respiratory Society UK.
Editor
Dr Iain Small, PCRS-UK Executive, General Practitioner, Peterhead
Editorial boardDr Noel Baxter, Chair PCRS-UK Executive, LondonCarol Stonham, PCRS-UK Nurse Lead, GloucestershireSally King, PCRS-UK Education Committee and RespiratoryPhysiotherapist, GloucestershireDr Basil Penney, GPwSI in Respiratory Medicine, DarlingtonAnne Rodman, Independent Respiratory Advanced NursePractitioner and Education for Health Regional Trainer, LichfieldRuth Thomas, Senior Community Respiratory Nurse, Milton KeynesSteph Wolfe, Independent Respiratory Nurse Specialist (Primary Care)
PCRS Chief ExecutiveAnne Smith
Communications Consultant and Freelance JournalistFrancesca Robinson
Policy AdvisorBronwen Thompson
PCRS Operations DirectorTricia Bryant
Competing interests are declared to PCRS and this informationis kept on file.
The opinions, data and statements that appear in this journal are thoseof the contributors.
The publisher, editor and members of the editorial board do notnecessarily share the views expressed herein. Although every effort is made to ensure accuracy and avoid mistakes, no liability on the part of PCRS, the editor or their agents or employees is accepted for theconsequences of any inaccurate or misleading information.
© 2018 Primary Care Respiratory Society UK. All rightsreserved.
Apart from fair dealing for the purposes of research or private study,criticism or review, and only as permitted under the Copyright,Designs and Patent Act 1988, this publication may only beproduced, stored or transmitted, in any form or by any means, withthe prior permission in writing of Primary Care Respiratory SocietyUK. Enquiries concerning reproduction outside those terms shouldbe submitted to Primary Care Respiratory Society UK [email protected]
The Primary Care Respiratory Society UK is a registered charityCharity No 1098117 and a Company limited by guarantee registeredin England Company No: 4298947. VAT Registration Number866 1543 09. Registered offices: PCRS, Miria House,1683B High Street, Knowle, B93 0LL.Telephone: +44 (0)1675 477600 Facsimile: +44 (0)121 336 1914Email: [email protected] Website: http://www.pcrs-uk.org
The Primary Care Respiratory Society UK is grateful to its corporatesupporters including AstraZeneca UK Ltd, Boehringer Ingelheim Ltd,Chiesi Ltd, Johnson & Johnson Ltd, Napp Pharmaceuticals, NovartisUK and Pfizer Ltd. for their financial support which supports the coreactivities of the Charity and allows PCRS to make its serviceseither freely available or at greatly reduced rates to its members. Seehttp://www.pcrs-uk.org/sites/pcrs-uk.org/files/files/PI_funding.pdffor PCRS statement on pharmaceutical funding.
Editorial Office and Publishers
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Tel: +44 (0)1675 477600Fax: +44 (0)1361 331811Email: [email protected]
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From time to time PCRS-UK publishes supplementsto the regular journal, which are subject to review bythe editorial board.
PCRS-UK also offers licencing opportunitiesfor bulk reproduction of this journal.For further information, contact:
PCRS (Primary Care Respiratory Society UK)Miria House,1683B High Street,Knowle, B93 0LLTel: +44 (0)1675 477600Fax: +44 (0)1361 331811Email: [email protected]
Printed in the UK by Caric Print Ltd, Bournemouth, Dorset inassociation with Stephens & George Magazines Ltd. Printed onacid-free paper
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Thecolourblockusedisa25%tint.
ThefontusedinHelveticaNeueinvariousweightstocreateahierarchyofread.
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PCRU-ContentsPage
Clinical LeadershipBefore After
Primary Care Respiratory Update
Contents
Special Features
Editor’s Round-UpIain Small
Chair’s Perspective: Influencing ChangeNoel Baxter
Asthma Guidelines in PracticeA PCRS Consensus
The Appropriate Use of Rescue PacksFran Robinson
PCRS National Respiratory ConferenceBuilding Confidence in a Changing World28-29th September 2018,Telford International Centre
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23
PCRS
Regular Features
What Else Can It Be?Doug and his BreathlessnessSteve Holmes
Getting the Basics RightManaging dilemmas in respiratory tractinfections and antibiotics prescribingKevin Gruffydd-Jones & Katherine Hickman
Supported self-management case historyChildhood asthma and respiratory infectionIain Small
Policy Round-UpBronwen Thompson
Journal Round-Up
PCRS-UK News Round-Up
Second opinionYour respiratory questions answered
Delivering Excellence Locally
Thinking differently about delivering pulmonary rehabilitation improved patients’ access toeducationFran Robinson, Karen Donaldson, Ali Brenton
Affiliated Groups
Clinical UpdateEvaluation of appropriateness of inhaledcorticosteroid (ICS) therapy in COPD andguidance on ICS withdrawal
Spring 2018 Issue 14 3
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ThePCRSlogocanbeusedtopleftorifdesiredthenewstethoscopeimagecanbesubstituted.However,wewouldrecommendthelogoispreferredheresothebrandingisclearwhenbeingreadonline.
Thepicturemastheadhasbeensimplifiedtocreateamoreassertiveuseofcolourandshapethatsegmentsthepage.
Leandesignhasremovedthedottedlinestopagenumbers,andmoreairinthelayoutmakesscanningacrosstonumberseasiertodo.
ThefontusedinHelveticaNeueinvariousweightstocreateahierarchyofread.
TheEditionnumberingsystemhaschangedtoalignwithdigitaleditions.
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PCRU-EditorialFeaturePage
Clinical LeadershipBefore After
Primary Care Respiratory Update
Chair’s Perspective: Influencing ChangeNoel Baxter, PCRS Executive Chair
Spring 2018 Issue 14 7
Helpprofilepicturestostandoutwithasmallborderline.
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Clinical LeadershipBefore After
Primary Care Respiratory Update
Second OpinionYour respiratory questions answered
PCRS Professional Development Develop Your Care Fitness
We know that there is a wide variation in
the standard of respiratory care provided
to patients, as demonstrated by national
reports such as the National Review of
Asthma Deaths (NRAD) and the COPD
the services
patients are engaged with/referred to but
also the level of training, educ tion and ex-
perience of the clinicians responsible for
the provision of such care.
‘Fit to Care’ is a PCRS publication aimed
at providing guidance for commissioners
and clinicians on the skills, knowledge and
training required by healthcare profession-
als working with patients with a respiratory
condition in a primary or community care
setting, irrespective of their profession.
The professional development section of
the PCRS website has now been rede-
veloped and structured around this docu-
practice and demonstrating the relevant
skills, knowledge and training required to
practice at each level. In a user-friendly for-
mat which is easy to navigate, the profes-
sional development web pages help users
review their own training requirements and
provide links to publications, resources
and relevant training opportunities to sup-
port healthcare professionals to develop
their skills and knowledge.
Try for yourself at
https://pcrs-uk.org/professional-development
How To Develop Best Practice
and training of those delivering respiratory
care and the barriers to getting additional
training. We want to get as many health-
care professionals to participate in our
-
ing respiratory care at the level to which
they are trained to do so and explore the
barriers to accessing further development
and training. Please join in and share the
survey with your colleagues and complete
the survey yourself at https://pcrs-uk.org/
– it only takes just a couple of moments.
QuestionI attended the PCRS conference in 2016 and there was a presentation by a physician who was talking about the use of blood eosinophil count as a useful criterion for inhaled corticosteroid use in patients with COPD. He also talked about its potential value in deciding whether oral steroids are appropriate for some patients when suffering an exacerbation. This spurred me on to look at the way we practice locally, as we seem to have a large number of patients accessing rescue packs with (sometimes) alarming frequency. As a colleague said, “We dish out rescue packs with antibiotics and steroids like sweeties”.
So, given the increased risk of pneumonia and other steroid-related side effects, should all patient rescue packs contain oral corticosteroids or should we be looking at each patient individually and possibly using the blood eosinophil level as a clinical marker to identify a subgroup of patients who should take prednisolone and a group for whom risk would outweigh benefit?
We could potentially reduce unnecessary long-term side effects and also make a prescribing cost saving – a ‘win-win’ situation. I've just started to look at the evidence as to whether this is a reliable enough marker and how it can be used (if at all) to make thesesort of decisions.
So, to my questions:
• Are there currently any pathways and local clinical guidelines out there that already incorporate this?• Is there any convincing data to support this strategy? In my literature review I identified the Hull & East Riding COPD pathway, but they only talk about using blood eosinophil levels as a marker to decide on withdrawal of inhaled steroids, not oral.
Answer: A debateDr Iain R Small, General Practitioner, Aberdeenshire
In brief, there is little evidence to support the use of oral corticosteroids in COPD exacerbations (Professor Alyn Morice, the physicianto whose presentation you refer, pointed this out with aplomb), but we all do it and patients seem to like them.
Working out which are 'infective' and which are 'inflammatory' exacerbations (should such differences genuinely exist) is extremelydifficult in real time, and in primary care I believe it to be almost impossible.
48 Spring 2018 Issue 14
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In Touch
Smoking rates at an all-time lowRespiratory News
Smoking rates in the UK are at an all-time low of 15.1%, reveals a new report published by NHS Digital
New guidance from fire chiefs on safe use of e-cigarettesNew guidance on the safe use of rechargeable e-cigarettes has been published by the National Fire Chiefs Council. PCRS-UK Chair Noel Baxter says this document should help allay any concerns clinicians may have about supporting patients who use e-cigarettes to stop smoking. Read the guidance in conjunction with this PCRS-UK practical resource.
New draft antimicrobial prescribing guidance sets out an antimicrobial prescribing strategy for acute exacerbations of COPD. An update to the 2010 clinical guideline on diagnosing and managing COPD in over 16s covers diagnosing and managing COPD in people aged 16 and over. PCRS-UK will be responding to the consultation. You can contribute to the PCRS response up to 24th July 2018.
NICE publishes new draft guidance on COPD
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Primary Care Respiratory Update
www.pcrs-uk.orgPrimary Care Respiratory Society
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Edition Highlights
Asthma Guidelines in Practice
Respiratory tract infectionsand antibiotic prescribing
Appropriate use of rescuepacks
Stepping down ICS in COPD
Spring 2018Issue 14
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