Asthma and COPD Transformation Programme

The Asthma and COPD Transformation (AsCOT) programme is a collaborative respiratory improvement project delivered across Liverpool as part of the Respiratory Transformation Partnership.

The programme focuses on people who have been recorded as having both asthma and COPD, a group often associated with diagnostic uncertainty, high use of urgent and emergency care services and lower access to guideline-based treatment.

Using population health intelligence from CIPHA, the programme proactively identifies patients who may benefit from further assessment and targets practices serving some of the most deprived communities in Liverpool. This helps ensure support reaches people at greatest risk of poor outcomes and health inequalities.

AsCOT brings together primary care teams, community respiratory services, specialist clinicians and accredited respiratory physiologists to deliver care closer to home. Patients receive a review of their existing respiratory diagnosis, access to any missing diagnostic tests such as spirometry and FeNO, and optimisation of treatment in line with current best practice.

A key feature of the programme is workforce development. Rather than specialist teams working separately from practices, clinicians work alongside primary care colleagues, building skills and confidence in respiratory diagnosis, investigations and management. This collaborative approach helps create a lasting legacy of improved respiratory expertise within local services.

By improving diagnostic accuracy, increasing access to respiratory investigations and supporting evidence-based treatment, AsCOT aims to improve outcomes for people living with asthma and COPD whilst reducing unwarranted variation in care across Liverpool.