Scenarios for asthma and pneumonia published to support improvements across the patient pathway

Two new scenarios for asthma and pneumonia have been developed by RightCare, supported by the Getting It Right First Time (GIRFT) programme.

RightCare scenarios support local health and care systems to think strategically about designing optimal care for people with long term or high impact conditions, and their carers. They help local systems understand how a patient’s outcomes and quality of life, and the cost of care can be improved as a result of shifting the pathway from a suboptimal journey to one that consistently delivers timely, evidence-based care.

The new scenarios for pneumonia and asthma highlight the key elements of optimal care across the patient pathway for both conditions. They put the person at the centre of the story, using a fictional patient to show the difference between a suboptimal (but realistic) pathway of care, compared to an optimal one.

For asthma, the scenario covers themes including:

  • using objective tests to support diagnosis;
  • training in correct inhaler technique;
  • ensuring everyone has a Personalised Asthma Action Plan;
  • the importance of urgent follow-up; and
  • monitoring asthma control.


For pneumonia, it covers:

  • appropriate use of antibiotics and antimicrobial resistance;
  • ensuring preventative measures are considered and embedded;
  • the importance of appropriate follow-up six weeks after completing treatment;
  • use of mortality risk assessments in primary and secondary care;
  • implementing the community-acquired pneumonia (CAP) care bundle;
  • providing patients with clear and timely information about pneumonia.


Each resource can be used as a framework to encourage commissioners and service leads to investigate opportunities for improvement for people with asthma or pneumonia.

Dr Martin Allen, GIRFT’s clinical lead for respiratory medicine (who is also NHS England’s national specialty adviser for physiological measurements and interim national clinical director for respiratory medicine), worked closely with the RightCare team on the scenarios and gave his support in a foreword to both documents.

He said: “Asthma and pneumonia are among the most common reasons for admission to hospital in England, causing millions of patients to be unwell, have time off school and work, and to be hospitalised.

“These new RightCare scenarios contrast the suboptimal care of these groups of patients with what good care looks like. We hope everyone working in respiratory care across local health and care systems will look at their pathways for pneumonia and asthma to see how they compare, and to identify where constructive changes can be made to improve outcomes for their patients.”

Both scenarios are now available on the NHS England website. Click below to find them. 

Supporting summaries of both scenarios, as well as additional RightCare resources such as data packs, can also be found on the RightCare FutureNHS site.

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