Quality Payment – Overuse of Asthma Treatment

Community pharmacy contractors passing the gateway criteria will receive a Quality Payment if they meet one or more of the Quality Payment criteria. The Department of Health has weighted these based on an assessment of the difficulty of achieving them and the benefit to patients for doing so, with each criterion being designated a number of points.

One of the Quality Payment criteria is:

‘On the day of the review, the pharmacy can show evidence of asthma patients, for whom more than 6 short acting bronchodilator inhalers were dispensed without any corticosteroid inhaler within a 6 month period, are referred to an appropriate health care professional for an asthma review.’


A suggested process for pharmacy teams to follow to incorporate this Quality Payment criterion into their daily practice can be found below.

Asthma referrals – Suggested process for referring patients for an asthma review (Word)

Asthma referrals – Suggested process for referring patients for an asthma review (PDF)

This process looks to identify patients who have been diagnosed with asthma and have been prescribed more than 6 short-acting bronchodilators in the last 6 months as these patients are likely to require their asthma to be assessed urgently.

Patients that fall into this criteria may benefit from receiving a check of their inhaler technique and an MUR to help them to understand how to optimise use of their medicines and management of their condition. If these interventions are provided, it is important that this is noted in the referral to the GP practice, so that they know that the pharmacy has already taken positive steps to address the patient’s identified issues with asthma management.

Data collection

Contractors may be required to provide evidence to local NHS England teams to show that they have met the Quality Payment criterion. A data collection form is provided below which could be used to aid this process. Please note, if this form is used, the left-hand side of the form containing patient information, should be hidden if it is shown to NHS England representatives to prevent a breach of patient confidentiality.

Data collection form – Patients referred for an asthma review (Word)

Data collection form – Patients referred for an asthma review (PDF)

Communicating with GP practices

The briefing document below can be used by contractors to talk local GP practice teams through the new referral process. This includes the main points that could be discussed with the local GP practice teams as well as frequently asked questions that contractors or team members may be asked, along with suggested answers.

GP practice briefing document (Word)

GP practice briefing document (PDF)

The below template letter can be used by contractors in addition to the briefing document. Although the letter could be used instead of the briefing document, it may be useful for contractors to speak to the local GP practice teams to inform them of the referral requirement rather than just sending a letter. This will allow contractors to hear what feedback the local GP practice teams would like to receive or how they would like patients to be referred.

Template letter for GP practice (e-form)

Template letter for GP practice (PDF)

Where the notification to the GP practice is undertaken via hardcopy/fax the Community pharmacy referral form can be used.

Community pharmacy referral form (Word)

Community pharmacy referral form (PDF)

PSNC guidance is available at ;


Resources and Guidance 

Asthma Referral pharmoutcomes briefing