Asthma remains one of the leading causes of A&E attendance and hospital admission in children and young people. Each attack signals poor control and increased risk of future exacerbations. NICE guidance, the National Bundle of Care, and the NCL Long Term Conditions (LTC) LCS require a 48-hour post-attack review and a full asthma review within 6 weeks.

What’s changing

Following a successful 9-month pilot in Haringey where review uptake rose from 20% to over 90%, this approach is being expanded across north central London. Automated daily alerts are sent securely to each GP practice’s generic NHSmail inbox, identifying eligible children who attended A&E and were discharged home. (See the example email sent to practices in the PowerPoint slides).

Inclusion criteria

• 18 months to 17 years with an asthma diagnosis code
• 5-17 years with a wheeze or viral wheeze diagnosis code
• Excludes children admitted to hospital and those in Islington, where the Paediatric Primary Care Nursing Team already undertakes this work.

What practices need to do

1. Admin team: Add the message to the patient record, pass to the duty doctor, and tick the confirmation button once done.
2. Duty doctor: Complete the brief 48-hour review (2-minute triage) using the ‘48-hour review’ page of the CYP NCL Asthma EMIS template (see image below).
3. Arrange a full asthma review within six weeks.
4. If the child has no asthma diagnosis, consider referral to the Respiratory Diagnostic Hublets.

A self-explanatory PowerPoint presentation is included to support discussion at practice meetings for both clinicians and administrators.

Join the drop-in Q&A session on Wednesday 19 November at 1.30pm.

This project strengthens asthma safety-netting and ensures consistent post-attack care across NCL.