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West Hertfordshire Teaching Hospital NHS Trust and Central London Community Healthcare NHS Trust provide both acute and community Respiratory Services for patients with Respiratory conditions across all four localities in South and West Herts place. The Integrated Respiratory Service will provide a multi-disciplinary hub, enabling assessment, diagnosis and management of patients with respiratory conditions in SWH. The service will provide access to multi-disciplinary team assessment, diagnostics, and treatment, improving the quality of care for patients. It focuses on clearly defined clinical pathways, GP support, advice and guidance and education. This service facilitates a truly integrated model of care enabling a resilient healthcare system for the future. To confirm as per the PSR direct award process C, the existing providers are satisfying the existing contracts, delivering a good service, meeting all KPIs, with no quality concerns and good outcomes and has very good feedback from GPs and patients and are likely to satisfy the new contracts. The proposed contracting arrangements are not changing from the existing contracts.