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Pathway improvement

We aim to capture all best practice across the whole pathway/system (primary, secondary and tertiary care) and summarise this in an algorithm or pathway publication.

Understanding Opportunities for Improvements

Implementation Tools and Resources

Asthma Biologic Pathway Transformation Fund Projects

The Pathway Transformation Fund (PTF) has been made available to NHS providers to deploy innovative ideas to overcome barriers to the adoption of Asthma Biologics within their locality. A list of the PTF project sites is available here.

Development of a consensus pathway/algorithm

  • A consensus algorithm to map the patient journey, from primary care through secondary care/specialist centres to advanced treatments; and also to set standards and reduce variations. This is an early draft version of what the pathway may look like. To be launched soon!

Grow home monitoring

  • Home monitoring – Asthma registry app. A remote monitoring solution for asthma biologics patients is currently being commissioned that will collect standardised outcome data and feed directly into the UK Severe Asthma Registry. To be launched soon!

Homecare and Self-Administration

Increasing the use of homecare services for asthma biologic treatment can increase the capacity for centres to see new patients and, improve patient access to treatment by reducing the need for patients to travel.

An introduction to asthma biologics homecare has been developed by the Oxford AHSN. Learn more about homecare.

To support centres and systems to understand variation in homecare utilisation for asthma biologics, a homecare dashboard has been developed. This can be made available through local AHSN leads.

Other relevant homecare resources

  • Paper A – BTS Mepolizumab Poster The poster recently presented at the British Thoracic Society Conference give reassurance that that not only do symptoms not deteriorate in patients that transition to homecare, but there is also a significant  improvement in ACQ6. d’Ancona G, Stewart-Kelcher N, Bains S, et al. P105 Does asthma control change when patients transition to home administration of mepolizumab? Thorax 2021;76:A144-A145.
  • Paper B – BTS Benralizumab Poster The poster recently presented at the British Thoracic Society Conference give reassurance that that not only do symptoms not deteriorate in patients that transition to homecare, but there is also a significant  improvement in ACQ6. d’Ancona G, Bains S, Stewart-Kelcher N, et al P104 Does asthma control change following transition to home benralizumab administration? Thorax 2021;76:A144.
  • Transfer Timescale to Patient Self-Administration for sub-cutaneous Biologic Therapy This sliding scale assessment guide and published paper support clinicians when deciding which patients could be considered for homecare provision.

Pharmacy enhanced roles

In October 2020, a survey was sent to pharmacists asking questions around current and future roles of pharmacists in supporting the severe asthma pathway. Pharmacists fed back that they could further contribute to the pathway by supporting identification and referral of at-risk patients, screening in-patients and establishing pharmacist-led clinics and training. The role of the pharmacist survey results .

In March 2021, a Pharmacy Clinical Sub-group, comprising pharmacists from all sectors, was established.  The sub-group has developed and presented a paper to the Working Group in June 2021 on the Pharmacy Role in Supporting Medicines Optimisation in Respiratory Medicine . This proposes a standardised integrated role for pharmacists where they lead on medicines optimisation and adherence for people with asthma. This was supported by the Working Group.

Resource toolkit to support embedding new roles

Enablers

Job descriptions

Case studies

Publications