Setting up asthma clinics in schools

The issue was highlighted when a young patient failed to attend reviews and ended up in A&E. We recognised that the impact of an asthma programme could be significant and discussed this with potential partners. We also found that children from deprived areas were more than twice as likely to require emergency admission following an asthma incident, so we focused our resources in these areas.

Instead of the parent attending the GP practice for a review, the nurse attends the school. The parent is invited to the review in that familiar and convenient setting. The school also receives training on asthma. The project is run by paediatric children’s asthma nurse specialist Gina Eyles.

The programme targets children under 16 and invitations are sent to any patients on the asthma register. The school also notifies us of any known asthma patients. We also search the clinical systems to identify these children.

The 10 schools involved have been enthusiastic and accommodating. Where school nurses exist, they have also been supportive. We aim to work with 1,000 children.

While most children (52%) had their asthma under control we found 12% were very poorly controlled and 28% were only partially controlled. We also looked at inhaler technique and found 69% of children required correction. The National Review of Asthma Deaths (NRAD) recommended that all children should have a personal asthma action plan. Research suggests annual reviews and a personal asthma action plan halve the incidence of hospitalisation. Before our asthma in schools clinics, 81% did not have an asthma plan. Now, 100% of those reviewed have an asthma plan. Following positive feedback, the integrated care board (ICB) has provided financial investment to facilitate the expansion of the asthma in schools plan to the whole of Norfolk and Waveney.

The local East of England Health of the Nation 2022 heat maps inform us of the highest areas of deprivation and prevalence of childhood asthma and pinpoint the hotspots we need to prioritise, namely Lowestoft and Great Yarmouth, with the continued aim of reducing inequalities. Reproduced from the Pulse Magazine article