Table 1

Consensus statements achieving very high consensus (≥90%)

No.TopicStatementLevel of consensus, %
1*Necessity to mitigate delaysEvery patient with suspected severe asthma should be seen within 12 weeks of referral to an appropriate specialist severe asthma service90
4Waiting times for accessing specialist severe asthma service† should be agreed and measured nationally and managed locally98
5*There needs to be a nationally agreed standard for waiting times for accessing specialist severe asthma service98
6An integrated care pathway would help improve the process of delivering care to severe asthma patients97
7Patient criteria (stratification) for referral to a specialist asthma servicePatients who continue to exacerbate despite adhering to high-dose inhaled steroid should be referred to a specialist severe asthma service94
9Patients who continue to require three or more courses of oral corticosteroids during the last 12 months should be referred to a specialist severe asthma service97
10Patients who require maintenance OCS of at least 5 mg daily for their asthma should be referred to a specialist severe asthma service100
11Referrals to a specialist severe asthma service† are mandatory if a patient has had a high-risk asthma attack requiring HDU/ITU support in the last 12 months97
12Health systems in the NHS should proactively case-find patients who meet criteria and flag for referral to a specialist severe asthma service92
14Role of the referring clinician when referring patients to a specialist asthma servicePrior to referral to a specialist severe asthma service, the referring clinicians must assess adherence to ICS of the asthma patient using an objective methodology for example, repeat prescribing on patient summary care records96
17Prior to referral to a specialist severe asthma service†, the referring clinicians must optimise inhaler technique with the asthma patient99
18*Prior to referral to a specialist asthma service†, the referring clinicians must offer an Asthma Action Plan to the asthma patient97
20The referral to a specialist asthma service should include information of inhaled corticosteroids prescribed98
23*Initiation of advanced therapies for severe asthmaOnce a patient has been approved by the severe asthma service MDT (or equivalent) for an advanced therapy, initiation of treatment should not be delayed by more than 8 weeks91
28*Clinical capacity issuesProviders and their relevant commissioners should ensure that their specialist centres have sufficient resources to meet patient demand97
29At present, there is insufficient resource to ensure that specialist centres meet patient demand90
30Where appropriate, technology-based methods of care should be adopted to improve the ability to meet the patient demand100
31*Role of homecareAll patients with confirmed severe asthma, on monoclonal antibodies, should have access to homecare, where clinically appropriate97
32*In accordance with local guidance, homecare should be offered as soon as is clinically appropriate96
34*Severe asthma patients receiving homecare should have appropriate access to their clinician when required98
36Not all patients with confirmed severe asthma may be appropriate for virtual (ie, remote) care100
37*The shift to remote delivery of severe asthma care should not exclude those that do not have access to the relevant technology93
38Performance measuresPatient-centred performance measures should be established and tracked100
39Results of performance measures should be published91
42National guidelines and statements relating to severe asthma care should be published from a single authoritative source91
  • *Statements shared with patients.

  • †Or equivalent specialist service for Wales, Scotland and Northern Ireland.

  • HDU, high dependency unit; ICS, inhaled corticosteroid; ITU, Intensive treatment unit; MDT, multidisciplinary team; NHS, National Health Service; OCS, oral corticosteroid.