Quality Payment Scheme support – document 9

Asthma patient review

The aim of this quality criterion is for community pharmacy to contribute to reducing preventable deaths from asthma through surveillance of patients’ use of inhalers. The quality payment encourages contractors to routinely carry out surveillance of patients’ use of inhalers ensuring patients are given appropriate advice and are referred for an asthma review when this is indicated.

TheNational Review of Asthma Deaths(NRAD) made a number of recommendations to improve the care of people with asthma. Community pharmacists are in an ideal position to detect the under and over usage of inhalers by asthma patients through surveillance of patients’ use of inhalers over a fixed period. This information may already be noted in pharmacies but this quality payment seeks to ensure this vital information is used to trigger an asthma review as recommended by the NRAD report.

Which patients should be referred for review?

Patients who have received six short acting bronchodilator inhalers with no inhaled corticosteroid inhaler within a six month period should be referred to an appropriate healthcare professional for an asthma review. Pharmacies will still be eligible to claim payment if no patients are identified who require a review, provided the pharmacy has evidence that it has been reviewing inhaler usage for patients.

Resources available to support pharmacies

Review of patients can be by any method and can include:

  • monitoring the number of SABA inhalers dispensed in a rolling 6-month period through the pharmacy patient medication records (PMR) or through routine or opportunistic access to SCR
  • monitoring patient emergency supply requests for SABA inhalers
  • monitoring out of hours or urgent prescriptions for SABA inhalers
  • monitoring emergency supply requests through theNHS Urgent Medicine Supply Advanced Service (NUMSAS)
  • monitoring repeat prescription requests for SABA inhalers
  • monitoring the number of SABA inhaler dispensed as part of aMedicines Use RevieworNew Medicine Service
  • monitoring non-collection of prescriptions for steroid inhalers.

A number of resources are available on the PSNC website at

These include a pharmacy process document, data collection form, a GP referral letter template and a GP briefing document if you get queries about the service from your local practices.

In addition, there is a referral template on PharmOutcomes which can be used to contact a patient’s GP practice. After logging in, click the ‘Services’ template and you will see the asthma referral service. Patient details recorded using PharmOutcomes, following consent to make the referral, will be emailed directly to the GP practice if the practice email address has been verified.