Summary

Asthma is a common health condition, affecting more than 5.4 million people in the UK. Up to 200,000 people in the UK have uncontrolled or severe asthma, which has a huge impact on the lives of patients and their families. Many are frequently admitted to hospital as an emergency or have potentially life-threatening severe asthma attacks. Patients with severe asthma may also experience serious side-effects from extended periods on high-dose steroid-based medication. (Source: Asthma + Lung UK)

Many severe asthma attacks and medication side-effects could be avoided through improvements to asthma care such as through early diagnosis, improved treatment, and self-management education. Asthma and respiratory disease are a key clinical priority for the NHS, as identified in the NHS Long Term Plan.

As a key partner of NHS England’s Accelerated Access Collaborative (AAC), the Health Innovation Network has supported the rollout of asthma biologics as part of the AAC Rapid Uptake Products (RUP) programme.

Biologic therapies for patients with severe asthma

New biological therapies are available to treat patients with severe asthma. Asthma biologics work in a targeted way, by disrupting pathways causing airways inflammation, helping to manage symptoms and reduce exacerbations. These therapies can transform patients’ lives by reducing long-term side effects of other treatments, such as steroids, and reduce the number of life-threatening asthma attacks.

It is estimated that in England over 60,000 patients currently living with severe asthma would benefit from an asthma biologic. However, 2021 prescribing data suggests that only 8-10,000 of these patients were able to access these treatments. (Source: NHSE BlueTeq data 2021) In order to improve patient access to these treatments, Asthma Biologics was part of the AAC’s Rapid Uptake Products programme, with AHSNs providing spread and adoption support from April 2021 to March 2023.

Led by Oxford AHSN, the programme focused on collaboration at a national, regional and local level across healthcare systems, industry partners, patients, and the community and voluntary sector to improve access to asthma biologics.

AHSNs worked within their individual systems to support asthma pathway improvements by taking a pathway-based transformation approach. AHSNs provided clinical and transformation leadership, shared best practice and developed education and implementation materials for those involved in providing asthma care.

A package of educational resources, including information documents, podcasts, posters, learning modules and webinars, was created to support clinicians. The Asthma Biologics toolkit was designed in a practical way to support teams adopting and sustaining the use of asthma biologics.

The Asthma Biologics programme also worked collaboratively with the AHSN FeNO programme, which aimed to improve access to FeNO testing in primary care.

Outcomes

The programme aimed to improve patient care and outcomes through enhanced access to diagnostics and treatments for severe asthma. Key impacts include:

  • More than 4,690 new patients began receiving life-changing biologic therapies.
  • Around 3,000 fewer patients are now receiving high-dose (3g or more) oral steroids each month.
  • More than 140 patients using the myAsthmaBiologics app which supports patients prescribed asthma biologics to manage their asthma at home and allows their clinical teams to monitor them remotely.
  • 9 Pathway Transformation Fund projects were completed to support wider adoption of asthma biologics.

For the clinical workforce delivering asthma care the programme has supported learning, training and development.

  • More than 1,000 people attended live webinars on asthma biologics while 493 people completed e-learning modules.
  • The Asthma Biologics toolkit had more than 21,600 users during the two-year programme.
  • The asthma consensus pathway was launched, providing a new set of standards based on best practice to guide how to deliver optimal care across the entire patient journey.

Next steps

The national Asthma Biologics programme has now completed and has made substantial contributions to the transformation of asthma care in England while significantly increasing the access to and adoption of asthma biologics. Learning from the FeNO and Asthma Biologics AHSN programmes is being fed into the development of NICE/SIGN/British Thoracic Society asthma guidance, expected in 2024, offering real world insights to implementation considerations.

There are opportunities to continue this work and improve asthma care by enhancing rollout of the innovations and ensure more patients can benefit. The toolkits, training modules and other resources created during the programme will remain accessible to NHS clinicians following the end of the AHSN programme.

The Health Innovation Network is transitioning to support healthcare inequalities as a national priority as part of NHS England’s Innovation for Healthcare Inequalities Programme (InHIP). Building on the transforming asthma pathways work, a number of AHSNs will support the respiratory aspect of the NHS England Core20PLUS5 approach, continuing to utilise the implementation and educational resources developed for the Asthma Biologics national programme.

Summary of resources

Below, you will find information collated to help you learn more about this programme’s aims, impact, and wider context, including evidence and information to support your implementation.

National enquiry

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