With asthma care shifting closer to home, primary care networks PCNs and integrated care boards ICBs are looking for solutions that improve outcomes without increasing clinical burden. Fractional exhaled nitric oxide FeNO testing is emerging as a vital part of this model, providing objective data that supports both diagnosis and long term management within community settings.
FeNO enables consistent, evidence based care across practices, reduces variation and gives clinicians the confidence to act earlier. This makes it a valuable tool for PCNs and ICBs working to deliver high quality, cost effective respiratory services.
Why PCNs and ICBs are prioritising FeNO
Asthma remains one of the most common chronic conditions managed in primary care, and it accounts for avoidable hospital admissions every year. Managing it well requires appropriately targeted treatment, structured reviews and early identification of deterioration.
FeNO testing strengthens each of these steps by:
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Identifying airway inflammation
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Supporting accurate asthma diagnosis
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Guiding inhaled corticosteroid prescribing
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Tracking response to treatment
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Preventing unnecessary escalation or specialist referral
Standardising care across practices
PCNs and federated practices often face variation in asthma care due to differences in resource availability, training and diagnostic tools. Introducing FeNO testing across a network offers consistent clinical assessment from one surgery to another.
This standardisation supports:
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Shared clinical decision making
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Reliable outcome measurement
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Better patient experience regardless of postcode
Reducing referral pressure on secondary care
Hospital respiratory services continue to experience growing demand. Many referrals arise because primary care clinicians cannot confirm diagnosis or treatment appropriateness with confidence.
FeNO testing supplies the missing information where:
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Lung function is inconclusive
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Symptoms are variable
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Paediatric assessment is difficult
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ICS decisions are unclear
With objective data available in primary care, referrals can be reserved for patients who truly need specialist intervention.
Supporting ICB priorities and population health
ICBs are tasked with improving outcomes, reducing health inequalities and enhancing system efficiency. FeNO aligns strongly with these goals.
It helps ICBs:
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Implement evidence based asthma pathways
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Reduce avoidable A&E attendance
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Improve medication stewardship
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Target support where disease burden is greatest
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Generate measurable clinical improvement
For population level monitoring, FeNO also provides data that can be aggregated and analysed across PCNs, enabling informed commissioning and service planning.
Flexible delivery models
FeNO testing can be implemented across PCNs and ICBs in several ways, depending on workforce and clinical structure.
Common approaches include:
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GP surgeries adopting FeNO as part of routine asthma assessment
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Community respiratory clinics testing referred patients
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Shared PCN equipment models to maximise access
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Hub-and-spoke systems linked to hospital respiratory teams
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Nurse-led FeNO assessment as part of chronic disease reviews
Each approach enables earlier diagnosis and more responsive management within local contexts.
A cost-efficient addition to asthma care
With careful product selection, FeNO testing is both affordable and sustainable. Devices with low running costs and long life components are ideal for high volume community models.
Benefits to ICBs and PCNs include:
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Reduced repeat appointments
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More accurate treatment steps
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Fewer inappropriate prescriptions
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Prevention of exacerbations and emergency care
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Better workforce utilisation
Transforming outcomes across the system
By embedding FeNO within PCN and ICB frameworks, asthma care becomes more proactive, precise and patient centred. Clinicians gain confidence, patients gain clarity and systems benefit from fewer preventable crises.
FeNO is not simply a diagnostic aid. It is a scalable tool that enables high quality respiratory care to be delivered where patients need it most, in their communities.
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