Children’s asthma services need to be commissioned in a seamless integrated fashion across the entire pathway from prevention and self-management to in hospital and out of hospital care. This section provides information, advice and resources to support those commissioning children’s asthma services.
NHS England commissions severe and difficult-to-control asthma services from five highly specialist respiratory centres for adults. NHS England has produced a manual of prescribed services defining ‘difficult’ asthma as:
- An event of acute severe asthma which is life threatening, requiring invasive ventilation within the last 10 years
- Requirement for maintenance oral steroids for at least six months at a dose equal to or above 7.5 mg prednisolone per day or a daily dose equivalent of this calculated over 12 months
- Two hospitalisations within the last 12 months in patients taking and adherent to high dose inhaled steroids (greater than or equal to 1000mcg of beclomethasone or equivalent)
- Fixed airflow obstruction, with a post bronchodilator FEV1 less than 70% of predicted normal
- Referred as an adolescent transition patient from a paediatric severe asthma service.
NHS England also commissions highly specialised allergy services from 18 centres across the country. All other allergy services are commissioned by CCGs.