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Introduction The Armagh & Dungannon Area falls within an area that is ranked 208/217 in the UK for Respiratory admissions and mortality (Asthma Lung UK, 2023). Currently, spirometry services in primary care (PC) is sporadic and conducted by practice nurses. Spirometry services were suspended during COVID-19 due to infection control concerns and now equipment has become obsolete and nurses deskille. It is also unfunded and not part of the GP GMS contract, making restarting services unattractive. There is also no direct GP access to investigations in secondary care, where waiting lists are 90 weeks for lung function and 5 years for routine consultants’ appointment. This has lead to long waiting lists in PC, delayed diagnosis and substandard care.Method A mobile advanced lung function service, led by a respiratory physiologist, that serves 22 GP practices in the Armagh Dungannon Area. The service offers x12 quality assured lung function appointments per week to include carbon monoxide transfer factor. Research indicates that 37% of patients with normal spirometry can have abnormal lung function, thus being missed at first point of contact (Sylvester et al, BMJ 2021). Practices also have access to FeNO using a cluster model with 8 machines being shared between 22 practices. Mentorship is also a key objective in reskilling nurses. Continuous auditing and feedback from patients and GPs to ensurec ontinous improvement.Results (@8 Months) 216 patients seen, 6.3% DNA rate, average wait time 8 weeks. 83 (38.4%) Normal lung function, 37 (17.1%) new asthma diagnosis, 39 (18%) chronic AFO, 17 other (7.5%), 40 (19%) require more testing in PC. 83 transfer factors performed – 17 (20.5%) abnormal.170 FeNO performed in mobile hub, 46 (27%) abnormal (>25 ppb). 54% of Asthma diagnosis could have been made with FeNO alone. (BTS, NICE, SIGN, 2024). 35% of patients with a definitive diagnosis and treated promptly in PC. Only 7.8% of cohort referred to secondary care for further investigation.Conclusion This service provides accessible, high-quality services to a rural community experiencing health inequalities. Implementing advanced tests in primary care settings is transforming patient care, ensuring timely and accurate diagnosis and better patient outcomes while reducing unnecessary referrals into secondary care.