Summary
Uncontrolled, severe asthma has a huge impact on the lives of 200,000 UK patients, including frequent emergency hospital admissions and serious side-effects from extended periods on steroid medication.
FeNO and asthma biologics are two innovations transforming the asthma pathway and improving patients’ quality of life through better identification and management.
"
It was only after a visit to the severe asthma centre that the first thing they did was a FeNO test. I’m not a typical asthmatic so sometimes I’ll wheeze and sometimes I won’t. I don’t present as a typical asthmatic but after blowing into the FeNO machine I was diagnosed immediately with severe asthma and my path changed.
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Patient participant volunteer Louise Reece-Jones
What the project involved
AHSNs in England have supported the rollout of two innovations under the Accelerated Access Collaborative’s Rapid Uptake Products Programme – FeNO, a point of care test to help diagnose asthma, and biologic therapies, NICE-approved treatments for patients with severe asthma which does not respond to regular treatments. Both innovations had lower than expected uptake, presenting an opportunity to improve take-up and support the NHS Long Term Plan ambition of improving early and accurate diagnosis of respiratory conditions by embedding both FeNO testing and asthma biologics into localised clinical pathways.
Led by Oxford AHSN (Asthma Biologics) and Wessex AHSN (FeNO), the project focused on collaboration at a national, regional and local level across healthcare systems, industry partners, patients, and the third sector to support the integration of both FeNO and Asthma Biologics into everyday practice.
AHSNs have worked within their individual systems to support asthma pathway improvements by providing clinical leadership, sharing best practice and developing supporting materials for those involved in asthma care.
A package of educational resources for each innovation, including information documents, podcasts, posters, learning modules and webinars, was created in order to equip clinicians with the tools and knowledge to support clinicians. The toolkits were designed in a practical way to support teams adopting and sustaining the use of FeNO and asthma biologics.
Patient information leaflets, translated into eight different languages, also aimed to empower patients to have informed conversations with their asthma team about their care.
Outcomes
The programmes aimed to improve patient care and outcomes through enhanced access to diagnostics and treatments for severe asthma.
Within the first year of the programme (2022-23), significant impacts were noted:
- More than 2,000 new patients began receiving life-changing biologic therapies.
- An estimated 102,700 additional patients benefited from FeNO testing across England.
- Fewer patients are now receiving high-dose (3g or more) oral steroids each month.
- More than £712,000 in grants approved, supporting the adoption of 218 FeNO devices (as of October 2022).
For clinicians and those delivering asthma care the programme has supported learning, training and development. During the first 12 months:
- More than 1,500 hours of specialist training was delivered to upskill those providing asthma care.
- Online resource toolkits for asthma biologics and FeNO have been accessed more than 10,000 times.
- The asthma consensus pathway was launched, providing a new set of standards based on best practice to help guide how to deliver optimal care across the entire patient journey.
These programmes are contributing to reducing underlying health inequalities in access to treatment.
Next steps
AHSNs are currently continuing to support their local healthcare systems to embed the innovations within their asthma pathways to transform asthma pathways and benefit more patients.
The FeNO and Asthma Biologics programmes are due to close at the end of March 2023. Toolkit resources will continue to be available to support wider adoption of the innovations.
Access the toolkits
