Transforming asthma care for adults across South West England

The South West and West of England Academic Health Science Networks (AHSNs), alongside the South West Severe Asthma Network (SWSAN), have been working with 10 hospital trusts across the South West of England to improve asthma pathways and enhance access to innovative treatments for adult patients.

A new evaluation shows the collaborative project, which was awarded NHS Pathway Transformation Funding for a one year project from September 2021, to increase regional uptake of asthma biological therapies (Reslizumab, Benralizumab, Mepolizumab and Omalizumab), has achieved a number of positive results:

• 961 patients are now receiving biologic therapies
• 294 new patients started biologic therapy during the project
• 87% of patients are now administering biologics at home
• a reduced time from referral to commencement of biologics
• 36% reduction in asthma ED attendance for patients on biologics (over 2 years)
• 9 educational webinars delivered with 80+ attendees
• Developed and consolidated the asthma Multi-Disciplinary Teams (MDTs) across the 10 acute sites, with all sites being linked with one of the four nominated severe asthma centres.
• A tool (RUBIC) was developed to enable primary care clinicians to refer directly to the severe asthma MDT meeting. The number of practices using the tool is growing with eight practices using it, and five further practices keen to commence.
• All sites have registered for ‘My Asthma Biologics’ app

Biological therapies can transform patient lives by reducing long-term side effects of other asthma treatments, help patients not responding to other treatments and reduce the number of exacerbations and life-threatening asthma attacks.

Asthma biologics were selected as one element of the national Rapid Uptake Products programme. The programme, delivered by AHSNs, sought to increase uptake of NICE approved diagnostics and treatments that have lower than expected uptake.

The work undertaken by the AHSNs and SWSAN also links to the respiratory NHS Long Term Plan ambitions “to improve the lives and outcomes of people with respiratory disease by diagnosing and treating conditions earlier and making sure that people with respiratory disease are receiving the right medication.”

Steve Johnson-Wood, Programme Director – Technology-enabled Care at the South West AHSN, said:

“This ambitious project encompassed Adult and Paediatric services across the South West, requiring system-wide collaboration and it was through this dedicated team effort that we were able to deliver such positive results. The project included the development of multidisciplinary team meetings at 10 acute sites, home administration, digital applications, educational workshops and the creation of a new referral tool. It’s a testament to all involved that so many more people in the South West with severe asthma can access high quality care and benefit from life-changing treatment.”

Listen to asthma patient Jo Beechcroft explain how access to biologic therapies is changing her life in a podcast from the AHSN Network.

This work took place alongside the launch, in June 2022, of a new asthma consensus pathway (developed by Oxford AHSN). The pathway intends to be a blueprint, guiding clinicians, managers and commissioners on what optimal asthma care should look like across the entire patient journey and leading to real improvements in outcomes. Access full and summary versions of the pathway.

Supporting improvements to asthma care pathways in paediatrics

Since September 2021, the South West and West of England AHSNs and Bristol Royal Hospital for Children have also supported a paediatric asthma project to improve care pathways and access to biologic therapies for children and young people. View our summary infographic for key project outcomes:

The South West AHSN has also been transforming asthma care through the adoption and spread of FeNO testing. FeNO devices measure fractional exhaled nitric oxide in the breath of patients. This provides an indication of the level of inflammation in the lungs, a marker which assists with the diagnosis of asthma and also helps to define the best initial treatment. We’ve driven the implementation of FeNO testing in primary care in the South West, improving patient access to faster and more effective testing.