Clare Slade, paediatric site practitioner and asthma big room coach, left, and Dr Lizzie McGeorge, above, at the weekly asthma big room

plan is that we’re able to use it across primary and secondary care and make it accessible to patients.”

The care plan is stored on the hospital’s electronic patient record system, then shared with the GP and patient through the Care Information Exchange, a digital patient portal that allows patients to access their records. This ensures that everyone involved in the patient’s care – including the patient themselves – has access to the same personalised information.

Since the launch of our digital asthma care record in December 2018, the proportion of children and young people admitted via A&E for asthma who left hospital with a care plan has increased to around 60 per cent.

“It’s still a new initiative and there’s work to be done to ensure progress continues, but the take-up shows we’re heading in the right direction.”

“ The great thing about our digital care plan is that we’re able to use it across primary and secondary care and make it accessible to patients.” Dr Lizzie McGeorge

Spring/Summer 2019


Major change requires a population-wide approach. Connecting Care for Children (CC4C), an integrated children’s health service founded by Trust paediatricians in 2014, responded to data about the prevalence of asthma among children in north west London by organising dedicated asthma clinics in our community. The team worked with GPs to  that included a review, inhaler technique demonstrations and general education. Junior doctor Dr Katelyn Aitchison attended the pilot clinic at Paddington Green Health Centre in February 2019. “The clinic involved a GP, consultant paediatrician and a trainee,” Katelyn says. “Each session was around 30 minutes, giving us time to understand each patient’s condition. I was able to take out a dummy inhaler and test it with the children, and we were able to successfully optimise each patient’s care. “These clinics are still in development, but there is an appetite to roll them out across north west London.”

ASTHMA CARE IN ACTION The changes are already making a  who attended A&E three times in one month this winter was treated with a

new approach on their third visit. The team reviewed the patient’s history, then referred the child to the providing assessment and treatment for children at home (PATCH) team, which is made up of experienced paediatric nurses who operate out of A&E. PATCH reviewed the child in A&E, reiterated the importance of inhaler technique and made sure the child and family understood the advice  patient a day after discharge, and advised the patient’s GP that an asthma review be undertaken.

As of March 2019, the child has not returned to A&E with asthma.

“There’s still a lot that needs to be done in regards to primary care and patient engagement but we are moving in the right direction,” Sharon says.


The Imperial Flow Coaching Academy approach involves applying team coaching and improvement science to  ‘big room’ meetings. Each big room   practical ways to improve their care and experience. The asthma big room takes place every Wednesday between 15.00 and 16.00 in the Eastcott room, eighth .

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