Paediatric Respiratory Dashboard: Improving Asthma Outcomes in SWL

South West London ICB

Project summary

In response to national evidence that 87% of children who die from asthma are prescribed ≥3 SABA inhalers annually, South West London (SWL) ICB identified a significant patient safety risk related to unsafe reliever overuse and poor preventer adherence. SWL had the highest proportion of ‘very high risk’ paediatric asthma patients in London, indicating an urgent need to prevent avoidable harm.

To address this, the Medicines Optimisation team developed a Paediatric Respiratory Dashboard to proactively identify children aged 5–18 at highest risk of asthma-related harm. Using EMIS ID data, the dashboard flags patients prescribed ≥6 SABA inhalers and ≤3 ICS inhalers within 12 months, a prescribing pattern strongly associated with increased risk of hospitalisation and death.

The dashboard enables real-time identification, recall, and clinical review of high-risk patients, shifting care from reactive to proactive safety management. It was embedded within a Medicines Improvement Scheme (MIS), requiring practices to review all flagged patients, supported by pharmacist-led education, practice visits, and prescribing guidance.

Across 173 GP practices, the intervention identified 359 high-risk children requiring urgent review. Following targeted action, there was a 26% reduction in high-risk patients, reflecting safer prescribing, improved preventer use, and better asthma control.

System-level data (ePACT2) shows a sustained reduction in high SABA prescribing, demonstrating reduced exposure to unsafe treatment patterns.

This programme represents a system-wide patient safety intervention, reducing avoidable harm, improving prescribing quality, and ensuring high-risk children are identified and treated earlier.