The challenge

Cornwall and the Isles of Scilly have a higher-than-average prevalence of asthma (7.5%) and chronic obstructive pulmonary disease (COPD) (2.3%), compared with the national average of 6.5% and 1.9% respectively. 

In the 20% most deprived areas of Cornwall, COPD morbidity is 44% higher compared to the 20% least deprived areas. Smoking rates are also elevated in deprived areas of the county.  

Patients living respiratory illnesses in the rural and coastal county face limited access to respiratory specialists as well as diagnostics including spirometry and Fractional exhaled nitric oxide (FeNO) machines.  

The solution

The Respiratory Transformation Partnership (RTP) is a national collaboration designed to improve the lives of people living with asthma and lung disease.  

Launched in March 2026, the programme brings together health innovation networks, NHS systems, leading industry partners, the Office for Life Sciences, and NHS England to shift care closer to home, support earlier and more accurate diagnosis, and enable better long-term management of respiratory conditions – reducing avoidable hospital admissions and improving patient outcomes. 

The Respiratory Transformation Partnership is building on the Pathway Transformation Fund, a national initiative which ran in 2025/26. NHS Cornwall and the Isles of Scilly was one of nine systems across the country awarded funding to deliver local projects to improve diagnosis and risk stratification for people with asthma and COPD.  

Our work in partnership

In 2025/26 we supported a six-month pilot in Cornwall and the Isles of Scilly, funded by the Pathway Transformation Fund, to identify and diagnose adults with asthma and COPD, as well as ensuring that those with COPD have access to the right care at the right time close to home.  

Nearly two thirds of GP practices signed up to address early and accurate diagnosis of COPD and asthma. FeNO machines were purchased and distributed to primary care and dedicated ‘lunch and learn’ training sessions took place to help health care practitioners accurately interpret FeNo machine results. 

With primary care teams, the team adopted a ‘Super Saturday’ one-stop approach: events in primary care practices or community locations in parts of rural and coastal Cornwall, delivering diagnostic testing to patients alongside education on their treatment and how to better manage their condition at home, as well as access other support services. This was extended to ‘Fantastic Fridays’ in some areas.   

The team utilised myCOPD and myAsthma to support with self-management, alongside a funded Facebook ad campaign to drive self-registration.  

Alongside bid support for funding, we also advised the system in Cornwall on roll-out, pulled together monthly progress reports, and shared best practice with wider sites and colleagues at other health innovation network organisations. 

Our impact so far

The six-month pilot in Cornwall and the Isles of Scilly in 2025-26, funded by the Pathway Transformation Fund, saw: 

• 132 spirometry tests 

• 212 FeNO tests 

• 391 rising-risk patients identified by multi-disciplinary teams  

• ‘One-stop’ Super Saturday review events for patients, extended to Fantastic Fridays in some areas 

• 87 OPTIMISE reviews conducted, to help assess current treatment for patients  

• 84 self-management education sessions delivered to patients, to help them better manage their symptoms 

• Onboarding of patients to the self-management caseload of the Hospital at Home Team, enabling early identification of deterioration and a step-up approach avoiding hospital admission 

• A significant increase in patient users of myCOPD and myAsthma 

• 36 confirmed COPD diagnoses  

• 56 confirmed asthma diagnoses.  

GP practices in Cornwall have seen increased engagement from patients. St Austell Healthcare has been holding regular diagnostic clinics and sharing this best practice with other primary care networks.   

In a survey of staff, 100% of respondents felt the pilot had enhanced collaboration through system working and improved patient experience with a coordinated approach to care.  

Effective joint working has been central to the delivery of the respiratory transformation project in Cornwall. Health Innovation South West has played a pivotal role throughout the programme, from initial bid development through to delivery, providing structured monthly reporting, acting as a trusted conduit for clinical and operational queries to the national team, and offering ongoing support to enable shared learning. This includes a planned collaborative evaluation day, helping to embed learning, assess impact and support sustained system improvement.”

Rachel Williams

Consultant Respiratory Practitioner (Physiotherapist), Cornwall Partnership NHS Foundation Trust and Clinical Lead Respiratory, Cornwall and Isles of Scilly Integrated Care Board

What’s next?

Health Innovation South West is the delivery and system engagement partner for the newly launched Respiratory Transformation Programme in the South West.  

The programme represents a new way of working across health and care, combining national coordination with local delivery. 

This year we are working with systems in Somerset, Devon, and Cornwall and the Isles of Scilly to support the implementation of new approaches that improve respiratory pathways and patient outcomes.  

This work will build on the Pathway Transformation Fund in Cornwall and the Isles of Scilly to speed up the diagnosis of respiratory disease in the region and improve treatment.