Respiratory
Overview
Respiratory illness affects around one in five people and is the third leading cause of death in England, after cardiovascular disease and cancer.
Conditions such as asthma and chronic obstructive pulmonary disease place a significant burden on individuals and the health system, with costs to the NHS estimated at over £4.9 billion each year. In total, lung conditions (including lung cancer) cost the NHS around £11 billion annually.
Risk factors such as smoking, poor housing, occupational exposure and air pollution contribute to higher incidence and mortality. As a result, people living in areas of social deprivation experience disproportionately worse respiratory health outcomes.
Areas of expertise
- Supporting pathway redesign and system transformation across primary and secondary care
- Project and programme management
- Delivering structured and evidence-based improvement programmes
- Enabling digital innovation and data-driven improvement, including remote monitoring and population health approaches
- Embedding public and patient involvement to ensure lived experience informs service design and delivery
Pulmonary Rehabilitation Competency Framework implementation

The challenge
The London Pulmonary Rehabilitation Competency Framework was developed to improve consistency in workforce capability across London. However, additional practical resources were needed to support its implementation in practice.
Solution
We co-developed a practical toolkit alongside the framework, mapped existing training offers, and identified gaps to support the development of a sustainable pulmonary rehabilitation workforce across London.
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Staff accessed individual competency records, with representation from at east one staff member in 27 of 32 London boroughs
Get in touch
If you are looking to establish diagnostic hubs, strengthen COPD winter planning, improve asthma management, or build self-management capacity, we can support you to develop and deliver effective solutions.
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