Information and resources to support primary and community healthcare professionals meet number 23 and 28 of the standards
Doing a thorough asthma review takes at least 20 minutes and should be a combination of clinical assessment and patient education. The child’s asthma plan should be reviewed and inhaler technique should be checked. The annual review template provided in our online toolkit outlines the questions to ask.
It is important to conclude the following through asking the right questions and following the steps included in the template:
1. Is this asthma?
2. Is it controlled?
3. Do I need to change management?
Undertaking an annual asthma review
Whittington annual review leaflet
You can also find asthma action plans here.
Dr Reena Bhatt and Dr Eugenia Lee walk you through how to complete an asthma action plan– watch here.
This comprehensive guide to asthma reviews was published in www.practicenurse.co.uk and is suitable for nurses and doctors.
The 48-hour review post discharge from ward or accident and emergency
The NICE quality standard 10 (2013) and the London Asthma Standard 16 (2015) require any child who has received treatment in hospital or through out-of-hours services for an acute exacerbation of asthma should receive a follow up by their own GP within two working days of discharge.
This review allows an assessment of the patient as they recover from an exacerbation and to review if their background control is optimal. The 48 hours is in keeping with observations that the majority of these children will have been discharged with at least three days of oral steroids following their exacerbation.
Acute care should ensure that notification of a child’s presentation out of hours or in an emergency is sent to the primary care provider with 24 hours. Primary care need to ensure that there is a system in place to flag these summaries and to feedback to the acute care provider if this requirement is not met.
Assessment of a child after an unscheduled visit
This leaflet aims to:
- Ensure that the person discharging the patient emphasises that the review is needed in 48 hours and not a week, month or other variation
- That the parent knows why the review is important
- That the GP or practice nurse, if shown the leaflet, knows what is expected.
One of the recommendations of the National Review of Asthma Deaths (NRAD) was the implementation of a National Asthma Template for consultations in primary care. On this page you will find a number of templates intended both as learning tools as well as for the purpose of recording good quality records in primary care.
This is divided into six sections which can be used as appropriate, depending on the clinical circumstances, starting with consultations where asthma is suspected. The powerpoint slides provide an overview of the template design.
- Suspected asthma – diagnosing asthma
- Routine review
- Assessing & treating acute attacks
- Post attack review
- Defining severity of attacks and some links
- Pharmacist concordance review
Using the EMIS asthma template
Any comments are welcome – to Dr Mark Levy FRCGP (Clinical Lead NRAD 2011-2014) firstname.lastname@example.org, www.consultmarklevy.com
Camden CCG and Whittington Health Template compatible with EMIS and can be adapted locally
North West London template
North West London Template compatible with System One that can be adapted locally
Asthma innovation and Research team run a schools programme providing asthma education through training medical students. They have also developed some useful resources for children including the Asthmanauts comic book, intending to help children with asthma learn more about their condition and how to use their inhalers. Parents and carers can help their child complete the comic book.