Organisational change needed to move towards net zero for asthma care

Smith and colleagues have provided a comprehensive but, one could argue, reductionist review of moving to net zero in asthma care.1Our experience in Greater Manchester is that greatest progress is made when there is clear leadership within an organisation and the employment of a “plan, do, study, act” approach. For example, when there has been resistance by patients to change to a dry powder inhaler, a change in practice to a more regular use of an inspiratory effort meter (inCheck) has been helpful in convincing patients of the suitability of such a change. Similarly, when there is no one taking lead in an organisation, there is little change in inhaler prescribing patterns.At a higher organisational level, the removal of the inhaler and asthma targets from the primary care network incentive scheme has taken the wind out of the sails of change just when imbedding that change was needed. This is…
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