Asthma  is one of the most common long-term health conditions, so why does access to diagnosis and treatment still depend on where you live, who you see, or even your ethnicity?

To mark World Asthma Day, we spoke with Carol Stonham MBE, a leading respiratory nurse, about what true accessibility in asthma care looks like and why we are not there yet.

The postcode lottery of asthma care

Asthma is a condition where we see a variation of care for many reasons; it’s vital that people with asthma symptoms have access to a quick and timely diagnosis, and those with an existing asthma diagnosis should have equal care, regardless of where they live and who their healthcare provider is. Access to a simple Fractional exhaled Nitric Oxide (FeNO) test is limited in some areas, meaning patients must travel out of their way to take this quick and easy test.

When it comes to care, one size doesn’t fit all, so it is important that care is adjusted to people within the local area. We are working towards a neighbourhood delivery of healthcare and planning services on a neighborhood basis to ensure that care is tailored to the local population.

Why FeNO testing is a game-changer

Asthma causes airway inflammation; more nitric oxide (NO) is produced when airways are inflamed. A FeNO test measures NO levels; a high FeNO level suggests airway inflammation and aids an asthma diagnosis but also guides healthcare professionals on their next steps in treatment.

The most recent guidelines for asthma care and management from the National Institute of Health and Care Excellence (NICE), the British Thoracic Society (BTS), and the Scottish Intercollegiate Guidelines Network (SIGN) now recommend a FeNO test as an initial test for diagnosis and asthma management. A FeNO test is quick, easy to use, and fits within a typical 10-15-minute consultation.

Barriers beyond geography

Healthcare professionals (HCPs) and patients must have the correct education. Unfortunately, there is no baseline level of asthma training for HCPs. Without training, it may be challenging to recognise worsening asthma control or inappropriate treatment. If the HCPs have the correct education, patient education will follow nicely; once patients understand their asthma, the treatment and how it works, they will be empowered to manage their condition better and, more importantly, understand when they need to seek help if things are not going well.

In the UK, patients in the lower social economic groups do not access healthcare, so it is more difficult for them to get information and testing. Some may be on the cusp of receiving free prescriptions, but then comes the issue of affording the medication. Some ethnic groups see long-term health conditions as a weakness, so it is vital to get messaging and education out to these communities.

The future vision

The biggest challenge in accessibility to FeNO testing for asthma care is funding; who pays for it? The Integrated Care Board (ICB) will pay for it in some areas, but this isn’t the case everywhere. In some places, it is down to the Primary Care Network (PCN); however, if they do not deem it a priority, it comes down to the individual General Practice (GP) surgeries. We need a strategy across the board where the ICBs take responsibility and ensure the funding is available for their area.

We cannot implement what the new NICE/BTS/SIGN guidelines are telling us to do without access to FeNO testing. Hence, we need to work with the campaigning organisations to demonstrate the full cost-effectiveness of FeNO testing. It would be great to get a system like the one they have in Gloucestershire, where a local enhanced fee is paid for each diagnostic test, meaning the payment received for every diagnostic test goes back into paying for FeNO testing consumables.

Asthma care should not be a guessing game, but without access to the right tools, that is exactly what it becomes.

Want to know how Gloucestershire is a model of accessible care? Or Carol’s expert insights? Watch the full interview here.

Bedfont® Scientific Limited promotes FeNO testing for asthma management.

Research from Asthma + Lung UK has found a significant rise in Accident and Emergency (A&E) visits from people experiencing breathing issues such as asthma. Asthma + Lung UK is a British charity formed in January 2020, with a dedication to improving respiratory health by focusing on asthma and lung diseases. The latest research shows over 42,000 patients ended up in emergency care in 2023/24 after visiting five or more times within the last 12 months, a 22.9% rise compared to the previous year1. Bedfont® Scientific Limited, a world leader in breath analysis, is calling for a wider adoption of Fractional exhaled Nitric Oxide (FeNO) testing to improve asthma management and reduce unnecessary hospitalisations.

The latest joint guidelines from the National Institute of Health and Care Excellence (NICE), the British Thoracic Society (BTS), and the Scottish Intercollegiate Guidelines Network (SIGN) recommend FeNO testing for asthma management in adults2. FeNO testing with the NObreath® is a non-invasive way for healthcare professionals to monitor airway inflammation, which is commonly found in asthma.

By including FeNO testing in regular asthma reviews, healthcare professionals can check a patient’s adherence to medication and adjust treatment plans. This allows better asthma control, which, in turn, reduces the need for emergency care.

An Asthma + Lung UK poll of 3,428 patients found that 49% said follow-up appointments were not offered for their condition1. The latest guidelines state that follow-up appointments and annual treatment reviews should be conducted for anyone who has ended up in emergency care2.

“Current NHS data shows a worrying pattern, asthma patients are repeatedly visiting hospitals without receiving the follow-up care they need,” said Jason Smith, CEO at Bedfont®. “FeNO testing can bridge this gap by providing early, precise insight into airway inflammation, ensuring patients receive the right treatment at the right time.”

With asthma-related hospital visits on the rise, Bedfont® joins Asthma + Lung UK in calling for the government to prioritise lung health in the upcoming 10-year health plan to prevent lung health from “falling to the bottom of the pile.” Greater investment in FeNO testing in primary care could reduce asthma hospital admissions.

Bedfont® is dedicated to improving respiratory health through innovative technology. The NObreath® FeNO device helps healthcare professionals diagnose and manage asthma accurately, reducing exacerbations and unnecessary hospital visits. Click here to discover how the NObreath® revolutionises asthma care.

References

  1. Surge in repeat hospital visits for lung conditions [Internet]. Asthma + Lung UK. 2025 [cited 2025 Mar 18]. Available from: https://www.asthmaandlung.org.uk/media/press-releases/surge-repeat-hospital-visits-lung-conditions
  2. ‌NICE. Overview | Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN) | Guidance | NICE [Internet]. Nice.org.uk. NICE; 2024. Available from: https://www.nice.org.uk/guidance/NG245

How FeNO testing with the NObreath® can aid an early asthma diagnosis in children.

As the world prepares to observe World Health Day on April 7th, 2025, Bedfont® Scientific Limited highlights the importance of early and accurate asthma diagnosis with its innovative NObreath® Fractional exhaled Nitric Oxide (FeNO) device. Whilst this year’s theme, Healthy Beginnings, Hopeful Futures, focuses on pregnancy and early life, Bedfont® is highlighting how FeNO testing revolutionises asthma care, ensuring children grow up with better respiratory health.

Over 262 million people worldwide have asthma, with 9.1% of them being children (aged 6-7)1. Undiagnosed or poorly managed asthma can lead to severe breathing difficulties, missed school days, and emergency hospital visits. Traditional tests like spirometry and peak flow meters do not always detect underlying airway inflammation, a common asthma symptom.

The NObreath® FeNO device provides a quick, non-invasive way to detect airway inflammation by measuring exhaled nitric oxide levels. Only one successful test is required for an accurate and reliable FeNO result with the NObreath®, helping healthcare professionals to diagnose asthma earlier and more accurately in children.

“For children, early intervention is vital,” says Jason Smith, CEO at Bedfont®. “The NObreath® is transforming how we detect and manage childhood asthma, giving young patients the best possible start in life. This World Health Day, we want to raise awareness of the importance of proactive asthma management and how FeNO testing can support a healthier future for millions of children worldwide.”

In November 2024, the National Institute of Care Excellence (NICE), the British Thoracic Society (BTS), and the Scottish Intercollegiate Guidelines Network (SIGN) published joint guidelines on asthma diagnosis, monitoring, and chronic asthma management. The guidelines recommend FeNO testing as a first-line test for asthma diagnosis in children with symptoms suggestive of asthma.

Carol Stonham MBE, NHS Gloucestershire ICB SW Respiratory network co-clinical lead, comments, “Asthma is the commonest long-term condition we see in children. If we can work with them to establish an early and accurate diagnosis and help them understand what asthma is and how their inhalers work, they will be able to manage their asthma more effectively and grow into young adults who are confident in getting asthma management right. FeNO is vital for the initial diagnosis but is also a great tool for fostering understanding of the inflammation we know is there but can’t see. With this understanding, children and their parents or carers can recognise when symptoms increase and know when to adjust inhalers or seek help.”

For more information on FeNO testing with the NObreath® visit the website by clicking here.

As World Health Day 2025 approaches, Bedfont® is committed to advancing respiratory health and ensuring that FeNO testing is available worldwide. This will allow healthcare professionals to help children breathe easier, stay active, and live healthier lives.

To read more about World Health Day 2025 and how FeNO testing is helping children with asthma, read our blog ‘World Health Day 2025: How FeNO Testing is Helping Children with Asthma’ [insert link to blog]

Read more: https://www.bedfont.com/world-health-day-2025-how-feno-testing-is-helping-children-with-asthma/

References

  1. The Global Asthma Report 2022 [cited 26/2/25] Available from https://globalasthmareport.org/burden/burden.php

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