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Background In December 2022, a workforce planning strategy enabled the transition to a physiologist-led CPET service in the paediatric respiratory physiology service, NHS Lothian. Historically all CPETs were medically overseen, however following a change in workforce staffing model, an opportunity presented to implement a change in CPET service provision utilising appropriate, existing, advanced practice skill set.There is now a requirement to evaluate effectiveness of this model for improvement to ensure the service continues to provide safe and accurate CPET provision long-term.Aims The aims of this evaluation were:To determine if a physiologist-led paediatric CPET service can provide safe, autonomous and accurate CPET provision.To determine if a physiologist-led CPET service can create efficiencies in medical time.Objectives The objectives of this evaluation were therefore:Evaluate the referral source of CPET referrals within the two-year period (identify the number of cross-specialism MDT sessions undertaken).Identify reasons for stopping CPET tests.Identify accurate ECG, safety and appropriate comments within interpretation.Calculate the number of hours saved in medical time.Methods Data from young people that underwent CPET testing in the two-year period from implementation (January 2023 to December 2024) were evaluated. Referral source, reasons for stopping tests, ECG interpretation, safety comments and the number of hours saved in medical time were reported.Results Data from CPET tests performed between the two timepoints (n=126) are presented in table 1:Abstract P50 Table 1Conclusions The paediatric respiratory physiology service can safely and autonomously perform CPETs with accurate interpretation and escalation to appropriate MDT for clinical discussion. The implementation of a physiologist-led CPET service has saved 189 hours in medical time from overseeing the test in the two-year period.