At the recent Best Practice Birmingham and Respiratory Professional Care Conference, the Respiratory Transformation Partnership (RTP) brought together national leaders, clinicians and implementation experts to explore how respiratory services can move from reactive care to proactive, population-focused models that improve outcomes and reduce health inequalities.
The session highlighted both the scale of the challenge facing respiratory services and the emerging evidence that transformation programmes are already delivering benefits for patients, clinicians and healthcare systems.
Why change is needed
Respiratory disease remains one of the biggest healthcare challenges in England. It is the third leading cause of death, and costs the UK economy an estimated £188 billion annually. Outcomes remain closely linked to deprivation, with preventable illness, hospital admissions and premature deaths disproportionately affecting disadvantaged communities.
During his keynote address, Prof Michael Crooks, RTP Clinical Lead and Professor of Respiratory Medicine at Hull University Teaching Hospitals NHS Trust, described the urgent need to redesign respiratory care around earlier diagnosis, proactive management and more equitable access to treatment.
A partnership approach to transformation
A key message from Seema Gadhia, Associate Director at Health Innovation Oxford and Thames Valley (HIOTV), was that sustainable change requires collaboration at every level of the system. The RTP, which is led by HIOTV, brings together NHS organisations, government bodies, academic institutions, professional societies, charities and industry partners around a shared vision for respiratory care. This coordinated approach helps reduce duplication, align national priorities and accelerate the spread of successful innovations across regions.
The programme is currently focused on four priority workstreams:
- Asthma Neighbourhood Development
- Asthma Biologics Access
- COPD Neighbourhood Development
- COPD Biologics Readiness
These are supported by workforce development, digital infrastructure and shared data programmes designed to enable transformation at scale.
Learning from transformation in Cornwall
One of the highlights of the session was a presentation from Rachel Williams, Consultant Respiratory Physiotherapist at Cornwall Partnership NHS Foundation Trust, who shared the impact of a whole-system approach to respiratory care funded through the NHS Respiratory Pathway Transformation Fund (PTF).
The programme engaged 35 GP practices, expanded access to fractionated Exhaled Nitric Oxide (FeNO) testing, delivered more than 660 referrals for respiratory diagnostics and introduced multidisciplinary reviews for rising-risk COPD patients. Importantly, the programme also addressed wider determinants of health through fuel poverty support, home insulation initiatives and energy advice.
The results showed promising reductions in emergency attendances, hospital admissions and salbutamol use, demonstrating the value of proactive identification and support for patients before they reach crisis point.
Improving diagnosis and outcomes in Wakefield
Dr Sarah Boot, Respiratory Consultant at Mid Yorkshire NHS Teaching Trust, presented another example of successful transformation also funded through the Respiratory PTF. Wakefield has significantly higher rates of COPD and asthma than the national average and has faced longstanding challenges around diagnostic capacity and workforce pressures.
Through proactive case finding, expanded diagnostic clinics, accredited spirometry interpretation and multidisciplinary reviews, the project delivered:
- 274 respiratory diagnostic tests
- 68 new COPD diagnoses
- 22 new asthma diagnoses
- 247 OPTIMISE reviews
- 94% patient satisfaction ratings
More than half of patients tested came from the most deprived communities, demonstrating the programme’s contribution to reducing health inequalities.
The importance of implementation science
The final theme explored the importance of implementation science in achieving sustainable change. Prof Judith Dyson, Professor of Implementation Science at Birmingham City University, emphasised that successful transformation depends not only on identifying effective interventions but also on understanding how to implement them successfully within complex healthcare systems.
The RTP’s delivery model reflects this principle by combining behavioural science, co-design and local adaptation with evidence-based clinical practice. This approach helps ensure that innovations are not only introduced but embedded into routine care.
Looking ahead
The conference session provided a compelling picture of respiratory transformation in action. While challenges remain around data sharing, workforce capacity, diagnostic access and unwarranted variation, the examples from Cornwall and Wakefield demonstrate that targeted, neighbourhood-based and data-enabled approaches can deliver meaningful improvements for patients and populations.
As the Respiratory Transformation Partnership continues to expand its work across England, its focus on collaboration, implementation science and proactive care offers a practical blueprint for addressing one of the NHS’s most significant clinical challenges.
Presented at the Best Practice Birmingham & Respiratory Professional Care Conference: “Respiratory Transformation in Reality: What’s Working, What Isn’t and What to Change”.
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