Introduction
NICE recommends that people with end-stage COPD and their family members or carers should have access to full range of services offered by multidisciplinary palliative care teams [1], but access to specialist palliative care (SPC) has historically been poor in this group [2]. Leeds Integrated Respiratory Palliative MDT was established in April 2018 to improve access to SPC and to improve collaborative working, initially for patients with COPD and latterly expanded to include other life-limiting respiratory diagnoses with representation from respiratory medicine (both hospital and community), SPC (hospital, community & hospice), community district nursing and psychiatry.

Methods
Retrospective analysis of data from last 4 years included: demographics, diagnosis, Recommended Summary Plan for Emergency Care and Treatment (ReSPECT), preferred place of death (PPoD) and actions taken by MDT.
Results
280 patients were discussed. COPD in 78% & 13% ILD. 96% were known to respiratory medicine and 41% to SPC. 36.4% patients were afterwards referred to SPC. Mortality in this group was 78% but 67% achieved PPoD, with ReSPECT initiated in 45% following MDT. 
Conclusion
Over the 4 years the MDT evolved from a pilot project to a well-established MDT with strong links to local palliative care and psychiatry services. It has demonstrated that integrated models of working across organisational boundaries lead to better co-ordinated care, improved advance care planning and increased access to SPC.
References

1.NICE COPD in over 16s:Diagnosis & Management.

2.Low uptake of palliative care for COPD patients within primary care in UK. Bloom CI et al Eur Resp J.2018 Feb