6 May 2014

RCGP Response to NRAD Report on Asthma

The RCGP said:

"Patients and GPs will be concerned - and very distressed - by these findings and we must do more to ensure that patients with asthma are cared for more effectively in primary care.

"Patients must also be reassured that asthma is a condition that affects milllions of people and in the majority of cases, it is managed well with the right treatment and appropriate monitoring.

"But it is a serious condition that can claim lives and as the audit clearly shows, there have been far too many cases where preventative steps should have been taken.

“Respiratory disease is a clinical priority for the College. The RCGP sets out a requirement for all trainee GPs to develop skills in diagnosing and managing patients of all ages and backgrounds with asthma.

"This requires GPs to adopt a patient-centred, team-based and organisational approach, including scheduled reviews and monitored safe prescribing, working effectively with primary care nurses, pharmacists and specialists. It also requires GPs to explain, encourage and support self-management strategies for asthma, according to the wishes and expectations of patients. These skills are tested in the exams which every doctor must now complete to enter independent practice as a GP.

"The RCGP recognises the training issues raised in this report and, for some time, has argued for improvements to GP training to meet the changing needs of our ageing population with increasingly complex conditions. We are working with Health Education England (HEE) and the Devolved Administrations to implement an enhanced four-year training programme for all doctors wishing to enter general practice.

"This new programme will enhance core GP skills in caring for patients with a range of conditions, including respiratory problems and provide an increased focus on the care of children, those with mental health problems, and older patients with co-morbidities – groups which are particularly at risk from poorly controlled asthma.

"To support GPs and trainees in improving their skills in caring for patients with asthma, the RCGP has produced a comprehensive and popular online training course, developed in partnership with the Primary Care Respiratory Society and Education for Health. This is available free to all healthcare professionals.

"But we can always improve and so we support the recommendations made in the report, particularly the use of personal asthma action plans for patients and the importance of regular reviews with patients at high risk.

" The RCGP is not responsible for setting standards for primary care nurse training but has argued for improved training and resources for nurses for some time. We would encourage practices to have an asthma 'champion' to help ensure that practice nurses and all practice staff have a good understanding of the condition and that procedures are in place to ensure that patients with asthma are getting the care and support they need.

"GPs work extremely hard and try to do the best for all their patients but we are really struggling to cope with spiralling workloads while funding for general practice has plummeted year on year and is now at an all-time low.

"We are calling on the four Governments of the UK to increase the share of the NHS budget given to general practice to 11% by 2017. This will ensure that we have more GPs, more appointments, and longer appointments for patients who need them most, including those with asthma.

"Over 90% of patients contacts are carried out in general practice for only 8% of the NHS budget. Unfortunately, today's findings highlight the serious consequences of this funding crisis."

Further Information

RCGP Press office - 020 3188 7574/7575/7576
Out of hours: 0203 188 7659



The Royal College of General Practitioners is a network of more than 44,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.