{
  "abstract": "Introduction Respiratory disease is a national clinical priority, with delayed and inaccurate diagnoses contributing to inappropriate treatment and avoidable referrals to secondary care. Historically, access to quality-assured spirometry and fractional exhaled nitric oxide (FeNO) testing in primary care has been variable. A pharmacist-led Respiratory Diagnostic Hublet within North Central London improves access to timely, standardised respiratory diagnostics across East Haringey. This service evaluation describes early activity, diagnostic outcomes and service utilisation following implementation of this model in primary care.Methods Diagnostic testing was primarily performed by trained Healthcare Assistants with interpretation provided by ARTP-trained clinical pharmacists. The RDH pathway is outlined schematically ( figure 1), highlighting pharmacist-led referral triage, selection of appropriate diagnostic testing and integrated clinical interpretations beyond spirometry indices alone. A retrospective service evaluation was conducted using activity data collected from the RDH between July and December 2025, including all adult and paediatric referrals. Data extracted comprised number of referrals, waiting time from referral to appointment, diagnostic tests performed, diagnostic outcomes and escalation to the respiratory multidisciplinary team (MDT). Descriptive statistics were used to summarise outcomes.Results Between July and December 2025, 394 patients (adults and children) were referred to the RDH for investigation of new respiratory presentations. Mean waiting time from referral to appointment was 11 days, enabling earlier diagnostic evaluation compared with traditional secondary care pathways. Diagnostic testing resulted in a confirmed respiratory diagnosis in 60% of patients, most commonly asthma and COPD. 31% of patients had normal respiratory test results and no diagnosis was made. Structured written interpretations of results were supplied to referring clinicians. Only 3% of patients required escalation for discussion at the respiratory MDT, with no paediatric cases requiring MDT input. The remaining 6% of patients were awaiting respiratory testing at the time of analysis.Conclusions Early evaluation demonstrates that a pharmacist-led RDH can deliver high-volume, quality-assured respiratory diagnostics within primary care, enabling earlier diagnostic clarification while reserving specialist MDT input for complex cases. This model supports accurate differentiation between asthma, COPD, overlap syndromes and restrictive disease, reduces inappropriate diagnostic labelling and provides an effective interface between primary and secondary care respiratory services.Abstract P7 Figure 1Pharmacist-led respiratory diagnostic hublet (RDH) pathway demonstrating referral triage, diagnostic testing and integrated interpretation to support appropriate use of specialist respiratory services",
  "authors": [
    {
      "affiliations": [
        "The Morris House Group Practice, London, United Kingdom"
      ],
      "name": "Deborah Bamgbola"
    },
    {
      "affiliations": [
        "The Morris House Group Practice, London, United Kingdom"
      ],
      "name": "Konstantinos Tzanidakis"
    },
    {
      "affiliations": [
        "The Morris House Group Practice, London, United Kingdom"
      ],
      "name": "Peter Magennis"
    }
  ],
  "title": "P7 Implementing a pharmacist-led respiratory diagnostic hublet in primary care: early activity and diagnostic outcomes",
  "uid": "1affcc73-def3-50ab-8362-71979b0f0f5a"
}