How a pharmacist-led asthma clinic is reducing health inequalities for children

A community-based asthma service in West Birmingham is delivering faster diagnoses, improved outcomes and more equitable care for children.

Little Lungs – Shaping Healthier Futures is a pharmacist-led initiative designed to address longstanding disparities in childhood asthma care.

The initiative was recognised at the General Practice Awards in December as the winner in the Advancing Health Equity category.

Developed in collaboration with Birmingham Children's Hospital, GP practices and local families, the service uses a targeted, one-stop model to identify and support children at highest risk of hospitalisation or poor control.

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Factors such as language barriers, low health literacy and fragmented care pathways often contribute to delayed diagnosis and poor management for children living in the most deprived areas of West Birmingham.

The Little Lungs service was shaped by feedback from families and local stakeholders, who highlighted the need for longer appointments, culturally appropriate communication and local delivery.

The team uses EMIS data to proactively identify children with poorly controlled symptoms, frequent unscheduled care or suspected undiagnosed asthma.

Those identified are invited to attend a local diagnostic clinic, based in their own GP practice. Each appointment lasts up to 90 minutes and includes lung function testing, FeNO testing, tailored education and a personalised asthma action plan.

The service is delivered by clinical pharmacists and designed to be accessible, with appointment invitations made by phone, in families' preferred language, and slots scheduled to fit around school and home commitments.

The Little Lungs initiative has seen referral-to-treatment times reduce from over 24 weeks to under four. Every child seen through the service has shown improved asthma control, and 99% of families have rated the experience as excellent.

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Of those seen, 82% received a confirmed asthma diagnosis, 5% had asthma ruled out, and 13% remain under review.

A parent whose daughter was seen through the service said they had spent years struggling to get a clear diagnosis, but within two hours at the clinic, received an accurate assessment and a new treatment plan that made an immediate difference.

Beyond clinical improvements, the service also addresses wider social determinants of health. The team works closely with neighbourhood teams, social prescribers and local authorities to identify and act on environmental triggers such as damp or poor housing.

The model also mitigates barriers caused by digital exclusion by offering personalised booking and communication methods that don't rely on online access.

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A national implementation toolkit, developed in partnership with Asthma + Lung UK and the Primary Care Respiratory Society, is supporting replication in other areas.

The model has already been shared at the 2025 NHS Confederation Conference as an example of pharmacist-led leadership in tackling health inequalities.