Accurately diagnosing asthma in children and young people (CYP) is essential for improving health outcomes and reducing pressure on the NHS.

The 2024 NICE/SIGN/BTS asthma guideline sets out a stepwise diagnostic pathway that relies on objective testing, and for CYP fractional exhaled nitric oxide (FeNO) testing is the key first step. 

However, access to FeNO testing across England remains limited with significant regional variations. 

Poor access to FeNO is leading to delayed or inaccurate diagnoses, unnecessary prescriptions, and missed opportunities for timely care. This is leaving children without the care they need while adding to pressure in secondary care. 

Good access to FeNO means better asthma control and fewer appointments for CYP and their families, and for the health service, it could save nearly £100 million through optimised treatment and reduced emergency admissions. 

To achieve this, the Taskforce for Lung Health is calling for: 

1. A FeNO Expansion Fund of £20 million over the next two years, prioritising primary care networks currently without FeNO access, to provide: 

• Over 2000 new FeNO machines. 
• Ring-fenced funding to keep the machines up and running, ensuring that devices are used routinely and kept usable for years to come. 

• Paid, protected training time for staff, ensuring that staff don’t have to choose between working and essential training. 

2. Health systems to better fund FeNO in their PCNs, making greater use of the resources they already have by better using current FeNO resources, ensuring that machines already in PCNs are usable, serviced (where applicable), placed with suitably trained staff and paired with sufficient supplies of mouthpieces etc.  

3. ICBs to publish data on FeNO access across all PCNs. 

Expanding FeNO testing is a vital, cost-effective step toward fair, high-quality asthma care for all children and young people — ensuring no patient is left waiting for an accurate diagnosis. 

Full briefing: Children and Young People’s asthma diagnosis

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