Asthma referrals

NHS England has now published its full guidance for the Quality Payments review date of Friday 15th February 2019. This section of the website is currently being updated to reflect the new guidance. The information below relates to June 2018’s Quality Payments.

Note: The information on this page is a summary of the requirements for June 2018’s Quality Payments. We strongly advise pharmacies to read the full NHS England guidance as well – there are links at the end of this page. Download this page as a PDF tip guide.

Asthma referrals (June 2018)

Points available: 20 points (£640-£1,280) available.

What’s involved:

On 29th June 2018, you must have evidence of referring asthma patients to an appropriate health professional for asthma review if they have been dispensed more than six short-acting bronchodilators in the last six months without corticosteroid inhalers.

If you claimed in 2017, you must have evidence you have identified and referred patients since 24th November 2017. You should also review staff awareness of the process for identifying suitable patients.

Patients in the target group may need an urgent assessment of their asthma. These patients may also benefit from the pharmacy carrying out an inhaler technique check and a MUR to help them understand how to manage their medication and inhaler.

Evidence required

  • Declare in your NHS BSA Quality Payments submission that you have referred these patients for review. Keep evidence of the referrals in your pharmacy.
  • If you don’t have patients in this category, you can still claim if you can demonstrate you have worked to identify people and have systems in place to refer anyone who would be eligible.

PSNC briefing on asthma referrals

PSNC has produced a detailed briefing including links to templates, flowcharts and other useful resources. We have summarised it below but recommend reading the full briefing.

 Identifying patients

You can identify patients (or demonstrate you have tried) via one or more of the following:

  • Monitoring SABA inhalers dispensed in rolling six-month periods via your PMR or by accessing SCR where appropriate
  • Monitoring emergency supply requests for SABA inhalers from patients / NUMSAS
  • Monitoring out-of-hours/urgent prescriptions for SABA inhalers
  • Monitoring repeat prescriptions for SABA inhalers
  • Monitoring SABA inhalers dispensed in MUR/NMS
  • Monitoring non-collection of prescriptions for steroid inhalers

As a minimum, every time a SABA inhaler is dispensed without a steroid inhaler you should check the dispensing history for SABA and steroid inhalers. The PSNC flowchart (available in the briefing) includes useful guidance.

Communicating with GPs

It’s important to notify the patient’s GP of any interventions, so they know the action you have taken to help the patient manage their asthma. If you do not currently refer patients for asthma review, you may find it useful to contact local GP practices first and check how they prefer to receive referrals. Use the resources in the PSNC briefing.

Data collection

  • PharmOutcomes has an asthma referral tool that you may find helpful in recording evidence for Quality Payments. You can access it via the Services link on the PharmOutcomes homepage. If you don’t have a log-in, contact the PharmOutcomes helpdesk.
  • The PSNC template (available here) is also a useful way of logging the action you’ve taken and patients referred for asthma review. Note: If you are sending this data collection form to commissioners, delete the bag label information on the left hand of the form so you don’t breach patient confidentiality.

 Full guidance from NHS England

This tip-sheet is just a summary. You must also read the full NHS England guidance to make sure you meet the Quality Payments criteria. There are 3 key documents:

  • Updated guidance for June 2018
  • Gateway Criteria Guidance
  • Quality Criteria Guidance