In Germany, there is a well-established scene being engaged in non-invasive mechanical ventilation (NIMV), but only a minority of centres for home mechanical ventilation simultaneously run a respiratory high-dependency unit (RHDU). There are no standardized concepts, and RHDU do not have official government recognition. However, due to the increased usage of NIMV in both intensive care units and RHDU, and the cost pressure in the health system, the current atmosphere is open for a co-operative strategy and gives respiratory medicine a unique opportunity to acquire a new profile. Therefore, both nursing and medical staff must receive training in NIMV-associated strategies.