Respiratory disease is a clinical priority of the NHS Long Term Plan. We are informed by NHS England and NHS Improvement that prior to the COVID-19 pandemic, an average of 2.25 million short-acting beta agonist (SABA) inhalers were prescribed per month in England. This over-use of aSABA inhalers can occur for multiple reasons and the work of the national respiratory programme is looking to address these issues as part of the NHS Long Term Plan, the Community Pharmacy Contractual Framework for 2019/20 to 2023/24 and the Quality Outcomes Framework (QOF).
These developments complement the work of other national quality improvement initiatives such as the asthma national audit programme.
The Community Pharmacy Contractual Framework for 2019/20 to 2023/24 includes: “The pharmacy can show evidence that asthma patients, for whom more than 6 short-acting bronchodilator inhalers were dispensed without any corticosteroid inhaler within a 6 month period, have since the last review point been referred to an appropriate health care professional for an asthma review”.
The QOF ensures all practices establish and maintain a register of patients with an asthma diagnosis in accordance with National Institute for Health and Care Excellence guidance. An update to the GP contract for 2020/21-2023/24 includes an improved QOF asthma domain. The content of the asthma review has been amended to incorporate aspects of care positively associated with better patient outcomes and self-management.