Primary Care Network COPD Risk Stratification and Specialist Support Service

This procurement opportunity invites Primary Care Networks (PCNs) and primary care organisations to deliver integrated neighbourhood-based respiratory services for patients with COPD across Hull and East Yorkshire. The project aims to improve patient outcomes through earlier identification and intervention using digital risk stratification tools and multidisciplinary specialist review. Successful providers will work alongside specialist respiratory teams at Hull University Teaching Hospital to proactively identify high-risk COPD patients, support preventative interventions, and improve access to specialist care within community settings, aligning with NHS priorities to shift care from hospitals to communities and from treatment to prevention. Providers must be a PCN or primary care organisation serving a registered population of at least 30,000 patients, with demonstrated capability in respiratory services, and operating in areas where recorded QOF COPD prevalence exceeds 2.5%. The project will test the feasibility and impact of this integrated neighbourhood model and generate learning to inform future commissioning decisions and potential wider adoption across the Humber region. This is a service redesign opportunity to build primary care capability while improving patient access to specialist respiratory support and preventative care.