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Working together to deliver effective asthma care

20th September 2017

The Hillingdon Champions of Asthma Team write about how they work with primary care and schools to achieve effective asthma care for the children and young people

The Champions of Asthma team is a multi-disciplinary team consisting of doctors, school nurses, specialist respiratory and allergy nurses. We work collaboratively with primary care and schools to achieve effective asthma care for the children and young people living in the borough of Hillingdon.

We started a pilot project focusing on two areas of Hillingdon with the highest hospital admission rates due to asthma and wheeze. Within these areas two community based clinics were created to review children as a follow up from secondary care or as new referrals from primary care. The clinics were also used to train and educate other health professionals. This formed part of the ‘Itchy Sneezy Wheezy’ initiative from St Marys Hospital Paediatric Allergy Department. A new paediatric Asthma pathway for Hillingdon was created which incorporated the London Asthma Standards (2015) and has now been implemented throughout the borough with the CCGs approval. The pilot was also successful in collaborating with local schools to highlight the value of closer working relationships between asthma nurses and school welfare officers to identify children with “slipping” asthma control.

We have added a further two community clinics to cover the whole of the Hillingdon borough, which in turn has reduced the number of hospital based appointments.  Outreach community clinics are closer to homes and schools, making appointments easier for families to attend, and to lessen the impact that asthma has on a child’s family and school life.

We are rolling out a scheme for schools and GP practices to aim for “asthma friendly status”. They will be awarded this by meeting key aspects of the London asthma standards.  This is to ensure primary and secondary care are working in harmony to promote good practice in asthma management across the borough.

The respiratory team work closely with the in-patient ward and the short-stay assessment ward in A&E to identify recurrent attenders, with day to day surveillance of all patients presenting to our department.  The aim is to intervene early and prevent re-attendance.  We have found this very useful for picking up children who have been to A&E several times but are not ‘on our radar’.  We will be extending this to A&E and Urgent Treatment  Centres (UTC) over the next few months.

From September we will be working closely with schools throughout Hillingdon to identify children with poor asthma control. The school welfare officers will be encouraged to keep a monthly record of all children requiring their reliever (salbutamol) at school or having days off school due to poorly controlled asthma/wheeze . These children will then be booked in for a structured review by a member of the respiratory team. The school nurses can also directly refer any child for an asthma review if they feel this would be beneficial.

Now that we have four successful community clinics our focus is moving towards providing more education and training for other health professionals who deal directly with children’s asthma care. These will either be delivered as in-house training, workshops, forums or directly within our community clinics.

Our local asthma network group, consisting of patients and their parents, asthma leads and champions, will continue to meet quarterly to discuss, share and plan the development of the project. Working together as a team we are on our way to improving asthma care for children and young people in our borough.

www.healthylondon.org/ask-about-asthma

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