The Motor Neurone Disease (MND) Year of Care Pathway Commissioning Tool was originally developed with health and social care professionals and people with MND and their carers in the London Borough of Wandsworth. The tool is aimed at commissioners of health and social care services help them improve the provision of services to people with MND. This document reports on a project to refine and validate the tool in Leeds before its launch in 2008. It provides an overview of the care pathway tool, looks at how it can help provide costing information and summarises what people with MND and their carers in Leeds thought about services. The MND then outline their hopes for the tool and how they plan to promote its uptake.