About the programme 

The Pathway Transformation Fund (PTF) was a national initiative from NHS England designed to accelerate innovation and improvement in respiratory care. 

After a highly competitive application process, nine health systems were awarded funding to deliver locally led projects focused on improving the diagnosis and management of asthma and chronic obstructive pulmonary disease (COPD). The programme ran from October 2025 to March 2026. 

In Cornwall and the Isles of Scilly, Health Innovation South West supported the Integrated Care System to deliver and evaluate the Respiratory Transformation Programme, helping partners implement new approaches to improve patient outcomes and strengthen pathways. 

Alongside local delivery, the programme was supported by a nationally coordinated evaluation to capture learning, build the evidence base, and inform future investment in respiratory transformation. 

National priorities 

Every project funded through the programme was designed to address two key national priorities for respiratory care:

• Early and accurate diagnosis 
   
  Improving access to high-quality spirometry is central to restoring respiratory diagnostic pathways. Projects are expanding access to quality-assured testing and strengthening referral pathways so that patients can receive timely and accurate diagnoses. 
   
• Risk stratification and optimisation 
   
  Partners are developing proactive approaches to identify people with COPD who are at rising risk of deterioration. By combining better data with integrated care pathways, systems can offer more personalised and preventative support to those who need it most. 

Our work in partnership

A national kick-off session brought funded sites together, marking the start of programme delivery.

Communities of Practice were established to connect funded and non-funded systems, enabling them to share insights, challenges and emerging good practice. 

Health Innovation South West supported the Cornwall and Isles of Scilly system through regular support sessions and by contributing to the national evaluation, ensuring learning from the programme was captured and shared.

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  

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.