This position statement outlines the rationale, core principles and practical steps for implementing risk-stratified asthma care across UK primary care, ensuring patients at medium and high risk receive timely review, optimisation of therapy and personalised support to reduce future risk.

In summary, the position of the Primary Care Respiratory Society (PCRS) is that:

1. Primary care teams should systematically identify adults, young people and children at increased risk of asthma attacks using evidence-based risk factors.
2. All people with asthma should receive a comprehensive annual asthma review, with more frequent follow-up for those with poor control, conducted face-to-face by healthcare professionals with appropriate respiratory training.
3. Inhaler technique, adherence and choice must be assessed and optimised at every review, ensuring treatment follows national and local prescribing guidance.
4. All those flagged should have an up-to-date personalised asthma action plan (PAAP), with accessible formats and patient/carer involvement.
5. Modifiable risk factors should be actively identified and addressed.
6. Risk stratification approaches must explicitly consider health inequalities.
7. Practices should maintain a coded risk register, supported by electronic alerts and recall systems, to ensure timely review and action for high-risk patients.