A need for a Sleep service led John O'Reilly to develop a Business Plan with the Health authority and Trust. A team  was trained  to provide a comprehensive Sleep service with CPAP and NIPPV programmes. Clinical Assistants were recruited and the service extended to neighbouring districts. Computer software was developed and networked to manage and audit reports.

Clinical care pathways were developed  for asthma and ventilatory failure. A trial of Nasal ventilation was established in an open admission  ward setting. We are  auditing it's clinical effectiveness compared  with usual care, using a protocol established and found to be safe over the past year.

An interest in the development of Pulmonary Rehabilitation led to  writing a protocol for an externally funded clinical trial.

Collaboration with the nursing team  and primary care colleagues led to the 'Blackpool Asthma Plan' shared care card and District audit database in over 30 practices. A COPD plan and database are in preparation.

Research in the past year has led to a published abstract on Asthma  delivery systems at  the European Respiratory
Society, Stockholm 1997 and
a paper in Respiratory
Medicine in January 1998.