Tackling NHS winter pressures due to respiratory disease: the UK Centre for Applied Respiratory Research Innovation and Impact (CARRii).

Seasonal respiratory viral infections are the major cause of increased pressure on national health systems such as the UK's national health service (NHS) during winter months. Emergency departments and hospitals are full as increasing numbers of patients require hospitalisation for lower respiratory tract infections and exacerbations of COPD, asthma, and other respiratory conditions. These winter pressures are largely predictable. Forecasting models give healthcare managers the chance to mitigate winter pressures by allocating resources more effectively. Despite this predictability and the production of NHS resilience plans, the UK is particularly susceptible to winter pressures. Communities facing social and environmental disadvantage are at increased risk of hospitalisation. Despite the focus on real-life research and guideline dissemination and implementation over the last 20-30 years, care of patients with respiratory conditions in the UK remains sub-optimal. To tackle winter pressures, a different approach is needed. The UK Centre for Applied Respiratory Research Innovation and Impact (CARRii) is a new UK-wide network which aims to drive policy change and use innovative ways of implementing research to achieve maximum impact on patient care. Its missions are to reduce NHS winter pressures and respiratory health inequalities, and its focus is on three areas: prevention; self-management and connected care; and optimisation of clinical care. CARRii unites leading experts across respiratory research, clinical medicine, data science, public health, industry innovation, and patient advocacy. CARRii's first Annual Scientific Meeting was held recently. Implementation of research is more likely to succeed if it is based on real-world data, there is multi-agency involvement in its design and implementation, it is patient-focussed, and policy makers are convinced of its benefits. By positioning implementation and impact as a central scientific goal, CARRii aims to show how healthcare systems can deliver respiratory solutions at scale. This requires investment and cross-sector collaboration. If successful, this approach will reduce winter pressures, improve health equity and strengthen system resilience.