Children and young people asthma audit 2019/20

It presents information on:

• 8,506 CYP who were admitted to hospital with asthma attacks on or after 1 June 2019 and discharged by 31 January 2020, and
• the structure and organisational of CYP asthma services between December 2019 and February 2020.

Data includes national and country level performance for key clinical process and organisational measures such as CYP exposure to second-hand smoke, the administration of systemic steroids within 1 hour, the provision of discharge bundles referrals for follow-ups in asthma clinics, availability of diagnostics tools and the organisation of hospital services eg staffing.

Key recommendations

For secondary care providers of CYP asthma services:

We have defined five key quality improvement (QI) priorities. They were chosen on a strong evidence base for their effectiveness for improving care, outcomes and service provision for CYP with asthma.

Clinical audit QI priorities

1. National QI priority C1: Record smoking status and exposure to second-hand smoke for 95% of children and young people.
2. National QI priority C2: Administer steroids within 1 hour of arrival at hospital to 95% and young people aged 6 years old or over, who have not received systemic steroids as part of pre-hospital care.
3. National QI priority C3: Provide 95% of children and young people with the following as part of their discharge bundle:
   - Review or issue of a personalised asthma action plan (PAAP).
   - Check of their inhaler technique.
   - A follow up appointment in a paediatric asthma clinic requested within 4 weeks.

Organisational audit QI properties

1. National QI priority O1: 85% of hospitals should have a respiratory nurse specialist trained in the care of children and young people with asthma.
2. National QI priority O2: 80% of hospitals should have access to fractional exhaled nitric oxide (FeNO), as a diagnostic tool for paediatric asthma services.

For children and young people living with asthma and their parents and carers:

1. If you are admitted to hospital with an asthma attack:
   • You should have a high dose of oral steroids within 1 hour of arriving at hospital (unless you had them before you came)
   • Someone should check that you know how to use your inhaler
   • You should go home with an up to date personal asthma action plan (PAAP)
   • You should be seen in a few weeks in a hospital asthma clinic

In some instances, you may not be able to ask for this yourself. If this is the case, we recommend your parent or carer does this for you.

  2. Children and young people and their parents and carers should advocate for the universal implementation of national quality standards across all hospitals.

  3. Children and young people and their parents and carers should consider participating in strategic groups, including those set up at network level, for paediatric asthma.

For a full list of the recommendations see our downloadable national audit report.

Patient and carer friendly outputs will also be published in due course. These will present key findings and recommendations for patients and their families and carers.

How to use this report

This report comes in three parts:

• Children and young people asthma audit (CYP) clinical and organisational audit 2019/20: Audit report - this presents key findings and recommendations for providers across the service including: governing bodies, commissioners, sustainability transformation partnerships (STPs), health boards, primary and secondary care providers and patients and carers.
• Children and young people (CYP) asthma clinical audit 2019/20: Data analysis and methodology report – this contains the full data analyses from which the key clinical findings and recommendations have been derived.
• Children and young people (CYP) asthma organisational audit 2019/20: Data analysis and methodology report – this contains the full data analyses from which the key organisational findings and recommendations have been derived.

Please note that all appendices for this report, including participation information and the full methodology, can be found in the clinical and organisational data reports.

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