Asthma: policy context
This section outlines the policy context relevant to asthma in Scotland. While there is no policy statement in Scotland that specifically focuses on asthma, policies on long term conditions and on allergic conditions are relevant.
Two Scottish health strategies - Delivering for Health (2005), Better Health, Better Care: Action Plan (2007), recognise the importance of a generic (rather than disease specific) approach to long term conditions, with an emphasis on self-management. The Scottish Government's approach to long term conditions stresses the importance of self-management. In addition to these, there was a prototype strategy called Good Places Better Health for Scotland's Children (2011) that looked at the key environmental influences affecting health of Scottish children with the focus on four main challenges, of which asthma was one. The World Health Organisation has also produced a 'Strategy for the prevention and control of chronic respiratory disease (113Kb) and has also established the WHO Global Alliance against Respiratory Disease (GARD).
Reviews of services
Audit Scotland published a report on Managing Long Term Conditions in 2007 which focused mainly on COPD and epilepsy but also made reference to asthma. A number of reviews of allergy services are potentially relevant to services for asthma. The Scottish Medical and Scientific Advisory Committee (SMASAC) published a review of immunology and allergy services in Scotland in 2000 and a subsequent report on allergy services in Scotland in 2009. In 2003 the UK Royal College of Physicians published a report entitled Allergy: the unmet need (1MB), which drew attention to the shortcomings of existing services for allergic diseases, the most common of which were asthma, eczema and allergic rhinitis. Asthma was also included in the 2004 House of Commons Health Committee review of The Provision of Allergy Services in England and Wales and in the 2007 UK House of Lords report on allergy. An update on progress was published in 2010 by the Joint Royal College of Physicians and Royal College of Pathologists Working Party entitled Allergy services: Still not meeting the unmet need. In May 2015 the Royal College of Physicians released The National Review of Asthma Deaths (NRAD), the review looks into the defficiencies that were found in routine asthma care and the recommendations to be taken forward for those who treat asthma patients, policy makers, pharmacists, NHS service managers and commissioners, patients and professional bodies.
Guidelines, standards and quality improvement work
Revised clinical guidelines for the management of asthma have been published jointly by the British Thoracic Society and the Scottish Intercollegiate Guidelines Network (SIGN) as SIGN 153.
In March 2007, the then NHS Quality Improvement Scotland (now Healthcare Improvement Scotland) published standards for asthma services for children and young people. A national overview of asthma services for children and young people was subsequently published in November 2008. NHS QIS also commissioned Asthma UK Scotland to review patient experience from the perspective of children and young people and the Asthma UK/QIS report from this review was published in November 2008.
Asthma is included in the Quality and Outcomes Framework (QOF) of the General Medical Services contract for primary care. Further information about asthma data in the QOF is available in the primary care data page in this section and data from the QOF in Scotland are available from ISD's Quality and Outcomes Framework (QOF) web pages.