1. Commissioning for Value Respiratory Pathway Clive Newman, Director of Transformation

2. Hardwick 2012/13 position based upon C4V indicative data, GEM deep dive evidential data and Right Care analysis: Higher than average prevalence of COPD (coal mining legacy) Higher than average smokers, especially during pregnancy Lower than average correct diagnosis of COPD. Lower than average using a self management plan. Higher than average non elective admissions: respiratory main cause and rising.

3. Four fundamental elements for successful change : Supportive senior executive team willing to take risk based on sound evidence. Focused project manager to deliver in systematic methodical manner fully inclusive of all stakeholders. All clinicians accepting and understanding its priority for improved patient outcomes. Solid and consistent patient engagement and representation at all levels, supported by the British Lung Foundation.

4. What has NHS Hardwick achieved to date? Respiratory delivery group; all stakeholders Spirometry competency assurance COPD self care diaries with bespoke welcome section & DVD Regular programme of educational events 3 active Breathe Easy Groups Smoking cessation programme ; CFC & Derbyshire Tobacco Alliance Improved pulmonary rehab provision; excellent patient outcomes. Designated respiratory medicines management lead Increased nebuliser access; direct reduction in NE admission Production of annual report to detail objective progress BLF to perform next evaluation Targeting of undiagnosed

5. Hardwick 2014/15 respiratory position Reduction in activity and spend 2013/14 - £170,000 Predicted reduction in activity and spend for 2014/15 - £410,000

6. Patient story: the most important evidence! www.hardwickccg.nhs.uk/news/2015/breathe-easy/