FeNO testing improving asthma diagnosis in region

The West of England AHSN has been supporting several projects to implement FeNO testing in primary care over the past six months.  There are now 16 GP practices across the region that have access to FeNO devices, with a further 60 practices planning to go live in the next two months.  The South West Respiratory Clinical Network has provided funding for a further 7 devices across the West of England region which improves access for patients.

FeNO devices measure fractional exhaled oxide in the breath of patients, which provides an indication of the level of inflammation in the lungs.  This can be used to aid in the diagnosis of asthma.  It is a quick and easy test that can be carried out by any healthcare professional that has received training.  Benefits of FeNO testing include:

  • improved speed and accuracy of diagnosis for patients suspected of having asthma
  • improved patient care and outcomes, reducing the risk of exacerbations and hospital admissions
  • reduction in inappropriate prescribing and referrals to secondary care

Following successful bids for Pathway Transformation Funding, Bath and North East Somerset, Swindon and Wiltshire CCG (BSW CCG) and Gloucestershire CCG were awarded funding to implement FeNO testing and are currently piloting the approach using a number of different models.

In BSW, FeNO testing is being made available to all GP practices in the region and is being supported by locality clinical leads in each area.  Many of these practices are currently using a mobile model and sharing FeNO devices to ensure equity of access for their patients, with some areas trialling a fixed hub model, with a view to comparing the two approaches in a project evaluation.

Nicci Mawer, Nurse at Combe Down Surgery said:

“We have been using the FeNO machine in my practice for a couple of months now.  I started using it with a degree of scepticism but can honestly say it is a valuable tool for aiding the diagnosis of asthma as well as monitoring existing patients who are uncontrolled and needing potential treatment change or can be informed that their current treatment is working.  It is easy to use and clean and can be done in a 10 minute appointment if you are only performing FeNO.  Patients find holding and breathing into the device quick and easy and it proves to patients that there is inflammation that needs dealing with.”

Gloucestershire received funding to introduce FeNO testing in 19 practices across one locality and are implementing this with a hub and spoke model, with staff attending training at a hospital clinic with a Senior Nurse Practitioner before receiving a device to use in their own practice. This has resulted in the CCG funding a wider rollout of FeNO testing across their whole region, with another 41 devices about to be deployed.

Funding and project support available

Whilst providing project management support to the existing FeNO roll out, the West of England AHSN is also able to extend this offer to individual Primary Care Networks looking to implement FeNO testing. The AHSN can co-ordinate training and signposting to educational resources, facilitate clinical pathway design and liaise with analysts around data collection. To promote the benefits of FeNO testing more widely, webinars have been delivered throughout December and January with 63 attendees from across the West of England.

The South West Clinical Network is really pleased to support this initiative as outlined by Adrienne Rogers, Clinical Network Manager:

“We’re delighted to support the extension of FeNO use across the South West Region by the provision of additional FeNO devices to map onto gaps identified from our Primary Care Respiratory Champion programme, plus thousands of mouthpieces to enable greater delivery for the region’s AHSN -supported FeNO projects in primary care.”

FeNO offers an opportunity to support both the early and accurate diagnosis of asthma, as well as monitoring compliance and effectiveness of asthma management. This will all help our regional systems to deliver on their commitment to the NHS Long Term Plan, and support our respiratory populations to access the right care at the right time.”

You can find out more about FeNO testing here.

If you’re interested in implementing FeNO  in your practice and would like to find out more about accessing funding and support please contact Senior Project Manager, Charlotte Hallett.

Find out more about the West of England’s work to identify gaps and priorities and signpost proven treatments and diagnostics through programmes such as Rapid Uptake Products and Med Tech Funding Mandate.