Background: Compared to other European countries, UK children with asthma have a greater risk of asthma attacks and death. Poor asthma reviews, including a lack of post attack reviews in primary care and little access to objective lung function tests for diagnosis and monitoring all contribute. We investigated whether a rapid access paediatric asthma hub for children with uncontrolled asthma is feasible and acceptable to families.

Methods: Between November 2021 and April 2022 the Leicester/UK Integrated Care Board board funded a pilot asthma hub for children aged 5 to 16 years taking referrals for 48 working hour reviews of children following an asthma attack. Children were reviewed and offered spirometry, bronchodilator reversibility and FeNO testing. Children and caregivers received asthma education and a medication review.

Results: 266 of 312 (85.4%) referred patients attended for review (42% female, mean age 8.6 years (SD 3.23)). Median time from referral was 2 days (IQR 1-3). Usable spirometry was achieved in 241 (90.6%) children, with 58 (21.8%) having abnormal baseline spirometry. 125 patients had acceptable FeNO measurements of which 50 (18.8%) had a FeNO ?25ppb. 73 (27.4%) patients had asthma confirmed as per European Respiratory Society criteria using 1st line testing. 3 children were acutely unwell and sent back to the emergency department.

Conclusion:  A paediatric asthma hub is feasible and acceptable to families. The hub effectively identified children with ongoing acute severe asthma and provided objective evidence for asthma in over a quarter of children. The impact of an asthma hub on medium and long-term outcomes remains to be determined.