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For an inhaler to be effective, the correct drug must be prescribed and the device must be used correctly.

The Primary Care Respiratory Society UK (PCRS) is increasingly alarmed by the widespread and accelerating loss of respiratory leadership, expertise and strategic capacity across Integrated Care Boards (ICBs), regional NHS structures, and Primary Care Networks (PCNs).

Asthma is a long term condition caused by inflammation of the airways leading to wheeze, cough, breathlessness and chest tightness. It is the most common chronic condition in childhood, affecting around 1.1 million children in the UK, equivalent to three children in every classroom. Many children with asthma also have atopy, meaning they are more likely to develop allergic conditions such as eczema or allergic rhinitis.

Respiratory disease and frailty should be considered jointly when caring for this vulnerable group of patients. Respiratory disease contributes to frailty and frailty must be considered when managing respiratory disease, in conjunction with other comorbidities, psychological and social issues.

The Primary Care Respiratory Society (PCRS) recognises that short-term respiratory admissions can be reduced but not always entirely avoided. These admissions occur when patients require hospital-based stabilisation, diagnosis or treatment which is not otherwise available to them in primary care. In line with the 10-Year health plan for England: Fit for the future, PCRS supports patient care in the community and care delivered closer to home.

With the introduction of a new Maintenance and Reliever Therapy (MART) license for children of 6 - 11 years old, PCRS has provided a summary of the new license and who it is appropriate for.

In this position statement we outline the background, key issues and provide key steps on how to make a firm diagnosis of asthma in this important group.

2024 marked a pivotal change in the management of asthma in the UK with the publication of a joint British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) guideline. This guideline, ‘Asthma: diagnosis, monitoring and chronic asthma management’, has the potential to be the paradigm shift that is needed to improve asthma care in the UK.In the 2024 BTS/NICE/SIGN guideline1 there is a clear statement that says: