Providing Successful Asthma Management in Pembrokeshire's Primary Schools
11 February 2025
An asthma review programme in Pembrokeshire schools is improving the day to day lives of children with asthma and empowering families to manage the condition effectively.
The North and South Pembrokeshire Clusters’ Asthma Primary Schools project has achieved remarkable results, providing essential asthma management and support directly within primary schools.
Delivered by a clinical pharmacist specialising in respiratory care, this innovative programme is providing support and education to children with asthma or asthma-like symptoms in 52 Pembrokeshire primary schools. With direct access to clinical records, the healthcare team is able to provide children and families with in-depth asthma assessments and educate them within the familiar school setting.
Funded by the North and South Pembrokeshire Clusters, this project helps children, families, and the NHS in managing the growing impact of respiratory conditions
“This isn’t just about improving the day-to-day for children with asthma symptoms; it’s about empowering them and their families to manage the condition effectively,” the respiratory clinical pharmacist explained.
“We’re maximising their symptom control by working directly in the spaces where children feel most comfortable. Our work showed that through close collaboration, we could implement meaningful, long-term changes to asthma management.”
Since the projected started in September 2023, it has empowered almost 400 children in Pembrokeshire to live well with their condition rather than suffer from it.
Over 60% of children had their treatment adjusted based on the latest All Wales Paediatric Asthma Guidelines to ensure they receive the best care. Every child was also trained on how to use their inhaler correctly and given a personalised plan to manage worsening symptoms, which was shared with their parents and school. The project also supports the use of ‘green inhalers’ which provides effective treatment while being kinder to the environment.
These results directly addressed the key issues highlighted in the 2014 National Review of Asthma Deaths (NRAD), such as poor awareness of risks, low use of preventer medication (puffers), over-reliance on reliever inhalers, incorrect inhaler techniques, and the absence of management plans for worsening symptoms.
Parents have praised the programme, with many saying it has improved their understanding of asthma medications and given them greater confidence in managing their child’s condition. One of the parents stated, “A game changer for my grandson, he now has more confidence to take part in sporting activities. He no longer feels short of breath when running”. Another parent praised the review process, stating, “The review was absolutely fantastic. It has been wonderful to feel ‘heard’ and have someone to discuss things with’”. In addition, a parent shared about the positive impact on their child's condition, saying “My grandson now has a new inhaler which has made a massive improvement’”
The respiratory clinical pharmacist further highlights the programme’s broader impact: “This project proves that community-based asthma care works. It’s a model that could be used in other areas to achieve similar positive results. The project underlines the importance of different organisations working together towards the same goal. These results would not have been possible without the significant efforts of the local authorities, primary school head teachers, the 12 GP practices across Pembrokeshire Clusters, and community pharmacy colleagues, combined with the invaluable advice and support provided by Professor Keir Lewis (respiratory lead for Hywel Dda) and Dr Ranjith Kulappura (the Paediatric lead for Hywel Dda) were instrumental in the success of this project. The project was a part of Bevan Exemplar Cohort 8 and presented at the Senedd in Cardiff in May 2024.
It has won numerous awards, including the 'Most Patient Centred Poster' category at the PCRS, the Jeffrey Parsons Memorial Prize at the Welsh Thoracic Society and the HDUHB Effective Clinical Practice Roadshow.
It has also been widely presented at various conferences including the Primary Care Respiratory Society Conference, and the Welsh Thoracic Society Autumn Conference, showcasing its innovative approach to asthma care. A successful abstract submission to the British Journal of General Practice Research and Publishing Conference in Manchester in March 2025 highlights its potential to influence national healthcare practices.
With its proven success, this project offers a model for expanding community-based asthma care, aligning with national healthcare goals and improving the lives of children with asthma.
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