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Asthma Audit Development Project

What we are doing

The Asthma Audit Development Project informed the specification of a national asthma audit to cover England and Wales, established what audit approach should be adopted and carried out some of the foundation work required.

A key recommendation from the National Review of Asthma Deaths (NRAD) national report Why asthma still kills was that 'a national ongoing audit of asthma should be established, which would help clinicians, commissioners, and patient organisations to improve asthma care'.

In 2015 the National Clinical Audit and Patient Outcomes Programme (NCAPOP) administered by HQIP met and agreed to assess whether an audit of asthma is possible. Subsequently, the RCP has been commissioned by the Healthcare Quality Improvement Partnership (HQIP) to scope the work. The Clinical Effectiveness and Evaluation Unit managed the project and Dr Shuaib Nasser was been appointed as clinical lead.


  • Phase 1: Exploration of areas which would benefit from national audit and, following analysis and stakeholder consultation, proposal of potential audit options to be taken forward for further investigation and feasibility testing in Phase 2. This phase was delivered by pH Associates of behalf of the RCP. The report produced from this phase can be downloaded from the information and resources page below.
  • Phase 2: Designing and piloting the dataset and audit option based on the accepted proposal from Phase 1 of the project. This phase of the project provided robust and informed recommendations on how the national asthma audit should be conducted. A final report was published in August 2018 and outlined the recommended audit methodology for a National Asthma Audit covering primary and secondary care.

What it covered

The AADP covered children and adults and was mainly focused on secondary care. However, it also explored and put forward recommendations on the incorporation of primary care data and investigated inclusion of prescribing data, pharmacy and ambulance service data and Patient Reporting Outcome and Experience Measures (PROMS/PREMS).

A steering group involving key stakeholders guided the work to assess how a national audit of asthma care could be delivered.

In March 2018 the National Asthma and COPD Audit Programme (NACAP) was commissioned. It will deliver audits of primary care (COPD and asthma), secondary care (COPD and asthma (adult and paediatric)) and pulmonary rehabilitation (COPD only).


  • November 2016: start of development project.
  • November 2016 – February 2017: Phase 1 – exploration of data collection options and examination of the use of PREMs and PROMs in a national audit.
  • March 2017: production of findings from phase 1 of the project to be shared with stakeholders.
  • May 2017 – January 2018: Phase 2 – development and piloting of a dataset and audit methodolody:
    • 31 July – 20 August 2017: public consultation of the clinical datasets (adult and paediatric)
    • 11 September – 9 October 2017: hospital pilot of the clinical and organisational datasets.
  • August 2018: final report of the project published.

Who's involved


The Royal College of Physicians has been commissioned by the Healthcare Quality Improvement Partnership (HQIP) to deliver this development project.

We have established a steering group that includes representation from:

Regular meetings of the steering group will take place during project development. 

What we have produced

The Asthma Audit Development Project (AADP): Phase 2 final report presents key findings, patient quotes, conclusions and recommendations for the next steps on how a national asthma audit should be conducted.

Information and resources provided by the Asthma Audit Development Project.