Information to support commissioners to deliver new models of care to improve asthma care for children and young people in London

Ideally future delivery will be through a more place-based approach. This would bring together potential stakeholders to work for the benefit of the child or young person and their family.

Get the London asthma standards for children and young people – these standards were most recently revised in December 2021. If you would like more background information about the standards, including the group that compiled and revised them, please see this version from 2020.

Visit these website to learn more about potential models for future delivery could be based on:

National Association of Primary Care: the Primary Care Home model

NHS England: Multi-specialty community hubs

NHS England: Primary and Acute Care systems

The King’s Fund: Accountable Care Organisations

A population-focused respiratory service framework developed by the Primary Care Respiratory Society.

Further information is available in the asthma models of care briefing

Commissioning an integrated asthma service

Asthma places a high burden on healthcare resources. Despite publication of evidence-based guidelines, morbidity and mortality remain unacceptably high.

An integrated whole system approach to care between the hospital and all out of hospital care settings with consistent implementation of current guidelines is key [1]. The child or young person’s journey needs to be supported by good communication between all partners needed to improve outcomes

Examples of out of hospital clinics

Croydon Hospital At Home

Croydon have developed a community home based visiting service which utilises both one to one and school learning, innovative social media campaigns and text messaging to focus on the prevention of ill health through education, effective self-care, and accessible and responsive services. 100% of patients visited have inhaler technique check and personalised asthma action plans. Croydon Case study

Launch article

Guardian article Asthma, pitbulls and education: a day in the life of a paediatric nurse

Twitter: @CHAHAsthma

Greater Manchester, Lancashire and South Cumbria (GMLSC) Primary Care Standards for the Management of Asthma in Children & Young People

The GMLSC Strategic Clinical Network have developed standards aimed at reducing variation in care and improving outcomes across all aspects of asthma care (0-19yrs) in primary, secondary and community care. This document draws together national best evidence and clinical consensus to set the minimum standards for care delivered to children and young people with asthma in Primary Care. Primary Care Standards Managing Asthma in Children & Young People

South Essex Project Access to 24/7 advice Integrated 24 hour children and young people’s asthma service: reducing unnecessary hospital attendance

A project in South East Essex demonstrated the importance of the educational role community nurses had with families and children.  Each child received a prep visit, annual review, acute call out(s) as required, 24 hour follow up and 2 week follow up which focused heavily on education as well as an asthma review. GP/consultant were informed via sharing of records and concerns were escalated as appropriate.  The project was positively evaluated by the families and fits with the Finnish 10 year asthma study which advocates community nursing support.

Please see asthma networks page for further information

[1] Chavasse, RJ, Kerr M, (2016) Asthma in children