1011 Shared care, shared responsibility by network approach: improving care for children with severe asthma

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<h3>Background</h3> Children with severe asthma (SA) suffer from significant morbidity and healthcare utilisation (Bush: 2017). Children with SA benefit from early multidisciplinary assessment of disease severity, access to novel therapies and management of comorbidities in partnership with a specialist severe asthma service. However, the threshold for primary/secondary care referral to such services in the UK is high (Carroll:2019). Unlike for adult severe asthma, a paediatric service is yet to be commissioned by NHS England (NHSE) which may contribute to variation in practice and availability of resources for management of children with SA. In 2019, health professionals from 11 hospitals in a UK geographical region and the multidisciplinary severe asthma service at their tertiary Paediatric Severe Asthma Service set up a network to improve care in their region. <h3>Objectives</h3> To describe the process of setting up a paediatric severe asthma network. To evaluate the experience of professionals participating within the network <h3>Methods</h3> Referral pathways, proformas for home visits, an investigation pathway, and adherence assessments were designed by designated professional groups. Input from patients and NHSE representatives was sought. Regular meetings between shared care centres were planned to improve communication, provide feedback, share good practices and empower local services in managing comorbidities and asthma education closer to the child’s home. A transition pathway is in place where young people with severe asthma and significant comorbidities, some of whom are on biological therapies, are discussed at the regional adult severe asthma multidisciplinary meeting, ensuring safe transition and care at an appropriate adult asthma centre. Eighteen months after the network for children with SA was set up, a survey was conducted of the network members to investigate the impact of being part of the network. <h3>Results</h3> 22 members of the network gave feedback including doctors (n=16), nurses (n=5) and a support worker (n=1). Members were asked to rate on a 10 point Likert scale whether they strongly disagreed (1) or strongly agreed (10) with several statements. Members rated the statements as follows: <h3>Conclusions</h3> Being part of the SA network was very positive for members’ own professional development and improving the care they provided to children with SA. The network remained valuable despite restrictions enforced by the Covid-19 pandemic. This is a model of shared working and learning that can and should be replicated elsewhere.