Respiratory illness features heavily in the NHS Long Term Plan.1 The well described drivers to improve outcomes in the most prevalent respiratory conditions, COPD and asthma, include variation in care standards and outcome2, and higher rates of mortality and hospitalisation than most other European countries3,4. In this paper we discuss how the National Asthma and COPD Audit Programme (NACAP) can support the aspirations within the long term plan to improve outcomes for people with COPD and asthma.