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Background Runcorn and Widnes have higher than national average levels of both malignant and non-malignant advanced respiratory disease as well as some of the highest levels of poverty and lowest literacy levels in the UK (Inequalities in life expectancy. Halton Joint Strategic Needs Assessment [internet] 2021). Consequently, morbidity related to breathlessness represents a significant burden on local respiratory, acute trust and palliative care services. Despite this, local services to support patients with breathlessness have been limited to a single hospice-delivered group programme of which uptake was poor.Aims The aim of this study was to enhance and extend the provision of breathlessness management services in the region, specifically:To review and update the existing breathlessness management programme (Group).To increase accessibility to breathlessness management services and enhance support for advanced respiratory disease patients.Methods Reviewing latest evidence supporting the Breathing, Thinking Functioning Model and the integration of a range of non-pharmacological interventions (Spathis, Booth, Moffat, et al. NPJ Prim Care Respir Med. 2017 Apr 21;27(1):27).Incorporating latest evidence-based psychological therapies relevant to managing chronic health conditions (Giusti, Papazian, Manna, et al. Front Psychol. 2022 Jan 27;12:818659; Konstantinou, Ioannou, Melanthiou, et al. J Contextual Behav Sci. 2023; 29:240-253).Incorporating patient feedback on how the existing programme could better meet patients’ needs.Expanding impact beyond the patient group format.Results 250% increase in the number of patients completing the breathlessness management programme over two years (2022-2024).Evidence of improvement across PROMs including Coping with Breathlessness Scale 90% improved (median 11.6 ,1-24), Perceived Global Health 60% improved (median 26.6, 10-45) and Breathlessness Anxiety 50% reduced (median 11.25, 4-17).High levels of patient satisfaction reported.Conclusion Despite delays due to the impact and financial legacy of COVID-19, work to update the breathlessness management programme has been completed with evidence of feasibility and enhanced accessibility, effectiveness and patient satisfaction. Referrals to and completion of the programme has increased. Work to extend services is ongoing including: providing additional online and printed resources, supporting relatives, and educating health care professionals/referrers.Grant funding provided by St. James’s Place Charitable Foundation, managed by Hospice UK.