Case Study:

NHS Wales Respiratory Toolkit

Unprecedented public health outcomes in chronic disease management


Treatment and care for people with long-term chronic conditions impose a significant burden on the NHS. These long-term health issues, including respiratory disease, require ongoing management and support, straining healthcare resources, and are estimated to take up around £7 in every £10 of total health and social care expenditure.

To tackle this challenge, ICST and NHS Wales partnered to empower patients to control their health, creating expert patients who are less likely to require NHS care and have enhanced well-being. This is a paradigm shift in healthcare, taking it outside the health system and into a patient’s own environment.


Respiratory Toolkit

The toolkit provides digital support for both patients and practitioners, promoting practices and behaviour change principles that result in improved outcomes and ultimately reduce the burden on the health system.

The Respiratory toolkit is structured into three layers:


Patient Self-Management Apps


Healthcare Professional Platform


Commissioner Data Reporting

By using implementation science and individual behavioural science methodologies, the toolkit achieves reach and adoption whilst achieving outcomes. This approach ensures seamless system installation without the need for additional resources or staffing. By practically supporting existing services, rather than imposing fundamental change, the toolkit minimises resistance, ensures sustainability, and achieves population-level reach and scalability.

Learn More About:

Respiratory Toolkit

A strategy to improve the standards of respiratory care across a health system, ensuring that all patients receive high-value care, and all healthcare professionals understand how to optimise the care for their patients.


Respiratory Toolkit

The digital approach to population-level behaviour change in Wales has had major outcomes, including improvements in patient wellness, changes in prescribing behaviours and reduced service needs.

Improved patient well-being and reduced healthcare utilisation

Among all users of the respiratory apps, 36% reduce their visits to the GP, and 19% reduce their admissions to A&E when they regularly use their app for more than six months.

Near-perfect coverage and no geographical variation in uptake

Where the Respiratory Self-Management apps have been implemented, including on a National basis, we see coverage of 100% of GP practices that have patients using the apps. There is no geographical variation in coverage (North, South, East and West), nor variation in Deprivation Index based on GP postcode.

Decrease in patients who rely on their reliever inhaler to stay well

Patients who do not need to use their reliever inhaler indicate that their asthma symptoms are well-controlled or minimal. App data shows a 48% increase in the proportion of users who do not use their reliever inhaler at all during the week.

Patients feel empowered to manage their condition

Of those patients, 90% surveyed said that the apps help them with self-management of their condition.

Interested to know how this toolkit could be implemented in your area?

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