New report shows impact of FeNO national programme on asthma care in England

A new report is showcasing the impact of a national AHSN Network programme to improve access to FeNO testing for asthma diagnosis.

Fractional exhaled Nitric Oxide (FeNO) tests are simple, non-invasive tests to measure the amount of nitric oxide in an exhaled breath – a biomarker for airway inflammation. FeNO testing can improve patient care by contributing to a faster and more effective asthma diagnosis, alongside a clinical history and other tests, and can be used to monitor patient response to treatments.

From April 2021 to March 2023, AHSNs in England supported the adoption and spread of FeNO under the NHS England Accelerated Access Collaborative’s (AAC) Rapid Uptake Products Programme. 

During the two-year programme an estimated 58,000 new asthmatics received a faster, more accurate diagnosis through the use of FeNO testing with an additional 1,200 FeNO devices entering use in primary care in England. It is estimated 53% of Primary Care Networks (PCNs) in England now have access to FeNO testing.

For some patients, gaining access to FeNO testing as part of their asthma care has been life-changing.

Emma Thompson, from Aldershot, provided a patient voice as part of the FeNO programme group, sharing her lived experience of severe asthma to inform the programmes. 

Emma said: “I was introduced to FeNO partway through my asthma journey and it revolutionised my care. It showed clinicians that, although I was on steroids and prednisolone, my airway inflammation level was still really high and I might benefit from biologic therapies. FeNO testing means my care is now focused around inflammation. It’s able to tell the clinicians how I’m feeling and get me on the correct medical pathway.”

The programme, led by Wessex AHSN, saw AHSNs work within their individual systems to support asthma pathway improvements by providing specialist implementation support and clinical leadership, sharing best practice, and developing supporting materials for those involved in asthma care. A FeNO implementation toolkit, which provided practical advice and support for teams adopting FeNO testing, was viewed more than 13,500 times and remains available for NHS staff to use. 

Joe Sladen, Associate Director Innovation Adoption and FeNO lead, Wessex AHSN, said: “The national FeNO programme has had a significant impact on improving access to FeNO testing across England, enabling more patients to benefit from a faster and more accurate asthma diagnosis. We’re excited to share our end of programme report and showcase our impact, learnings and overall reflections with our NHS colleagues, industry partners and patients.” 

Dr Andy Whittamore, GP, Clinical Lead Asthma UK and British Lung Foundation, and joint FeNO national clinical lead, said: “During the course of the programme we have seen a transformative approach to the use of FeNO testing in primary care and we estimate we’ve supported the correct diagnosis of 58,000 new asthmatics. There are now hundreds of additional FeNO devices in use across services in England, meaning more patients have access to quick, simple and accurate testing.”

Read the FeNO programme impact report on the Wessex AHSN website now https://wessexahsn.org.uk/projects/604/feno-programme-impact 

You can also watch Emma’s story below.