FeNO Programme Brief

Respiratory disease (asthma, COPD or another longstanding respiratory illness) affects one in five people in England and is the third biggest cause of death*. Around 1 in 12 adults in the UK are receiving treatment for asthma along with 1 in 11 children.

Asthma accounts for 2-3% of primary care consultations. It impacts on everyday life such as education and work, leads to 60,000 hospital admissions and 200,000 bed days per year in the UK. Asthma attacks kill three people in the UK each day and every 10 seconds someone has a potentially life-threatening asthma attack. However, many of these severe attacks and deaths could be avoided by taking simple measures to improve care. The key challenges for the health system with regards to asthma are early diagnosis, correct treatment and good education to enable self-management.**

As a result, respiratory disease is identified as a clinical priority in the NHS Long Term Plan.

The NHS Accelerated Access Collaborative (AAC) is the umbrella organisation for UK health innovation. It supports the NHS to quickly adopt clinically and cost-effective innovations, and to ensure patients get access to the best new treatments and technologies. It does this through the Rapid Uptake Products (RUP) programme. This programme delivers bespoke support initiatives to increase system wide uptake and spread. An industry guide to the programme can be viewed here.

The aim of the FeNO Rapid Uptake Product (RUP) programme is to:

• Improve patient care and outcomes by more effectively diagnosing patients with suspected asthma
• Increase widespread patient and clinician access to FeNO testing across primary care

What is FeNO?

A Fractional exhaled Nitric Oxide (FeNO) test is a way of measuring the amount of nitric oxide in an exhaled  breath. This test can help with the diagnosis of asthma by showing the level of inflammation in the lungs.

Benefits of FeNO - Clinicians (Primary Care):

• Faster and more accurate diagnosis within primary care
• Increased objectivity of patient evaluation by using fractional exhaled nitric oxide as a biomarker for the indication of active airway inflammation
• A positive FeNO test, alongside respiratory diagnosis and lung function tests, supports diagnosis which could otherwise be complex
• Reduced time taken for asthma diagnosis – test takes seconds to perform
• Potential for use in monitoring patient response to treatment by measuring their FeNO score before and after treatment – treatment could be adjusted accordingly
• Deemed as low risk for being aerosol generating as per published guidance from The Association for Respiratory Technology and Physiology (ARTP)
• FeNO is recommended by NICE as a diagnostic tool for asthma.

Benefits of FeNO - Patients:

•       More accurate diagnosis of asthma
•       Non-invasive, simple and safe test
•       Improved patient experience
•       Patients are less likely to be referred onto secondary care for additional testing
•       Opportunity for increased understanding of condition as patients can relate to their own FeNO score.

Sources:*Lung disease in the UK – big picture statistics | British Lung Foundation (blf.org.uk) **What is asthma? | Asthma UK