Strategy for change The British Lung Foundation wanted to test if integrating respiratory support groups into the local pathway produced a better understanding of health care services available and lung disease; increased medicine management and compliance; increased patient confidence and development of new skills. Did it also impact on control of health and demand on NHS services including unplanned hospital admissions?

Assessment The aim of this evaluation was two-fold:

1. A process evaluation: to look at the barriers and facilitators to integrating a support group into a respiratory care pathway.

2. An outcome, impact and economic evaluation: to measure impact on both physical and mental wellbeing and the benefits to NHS services, clinicians and commissioners

Methodology We employed validated questionnaires to measure physical, psychological and general wellbeing outcomes in participants. These were disseminated to control and test group at baseline and at 6 monthly intervals. Impact on NHS services was self-reported via telephone interviews with patients.

Effects of changes There was a self-reported 42% reduction in unplanned GP visits and a 57% reduction in unplanned hospital admissions compared to standard support groups.

People living with a lung condition who attended any type of support group had significantly greater quality of life at 6 months compared to control.

Those attending groups maintained quality of life throughout the study whereas quality of life decreased by more than 20% for patients in control group.

Those attending standard groups maintained self-efficacy whereas there was a decrease of 17% for those in control group.

For each pound invested in the integrated support groups there is a return of a minimum £3.43 and a maximum of £9.36.

For each pound invested in the integrated groups, there is a net gain of £8.01 in social return.

Lessons learnt Integrated respiratory patient support groups is a cost effective programme which has positive outcomes in terms of self-efficacy, health outcomes and wellbeing for attendees, providing cost savings and wider social benefits to local communities.