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The East of England Severe Asthma Network

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Severe asthma sufferers experience very frequent episodes of shortness of breath, wheeze and cough, and can suffer sudden attacks resulting in hospital admission. This is disruptive to all aspects of daily life. Many sufferers have required large doses of medication, including oral steroids, which can result in marked side effects over time.

The severe asthma service at Addenbrooke's Hospital acts as the hub for the East of England Severe Asthma Network. This network links up asthma specialists across this large part of England, helping to ensure that patients have access to a streamlined regional service.

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Introduction to the Severe Asthma Service

Severe asthma network video

Please have a look at this short animation that introduces the service and what to expect.

Severe asthma network video transcription

00:00:00:04 - 00:00:03:16
So you've been referred to the regional Severe Asthma Service.

00:00:03:21 - 00:00:05:00
What's next?

00:00:05:00 - 00:00:08:01
I imagine your asthma has been poorly controlled, perhaps

00:00:08:01 - 00:00:12:15
resulting in lots of symptoms such as a wheeze, cough and shortness of breath.

00:00:12:23 - 00:00:17:10
You probably need frequent courses of steroids and maybe hospital admissions.

00:00:17:21 - 00:00:21:18
As you know, the impact of severe asthma has on your life is significant.

00:00:22:03 - 00:00:23:15
So what's the plan?

00:00:23:15 - 00:00:27:01
Firstly, we need to establish and confirm the diagnosis of asthma.

00:00:27:12 - 00:00:30:03
We then need to work out which type of asthma you have.

00:00:30:10 - 00:00:33:04
We then need to look at some of the conditions that affect you.

00:00:33:09 - 00:00:36:12
And if we optimize them, we may help improve your symptoms.

00:00:36:18 - 00:00:40:00
Once we have completed that assessment, we can devise a treatment plan.

00:00:40:11 - 00:00:43:07
When you visit, expect to see the nurse and the doctor

00:00:43:08 - 00:00:46:24
and maybe some other members of our team, such as the physiotherapist,

00:00:47:04 - 00:00:51:06
a dietician, a pharmacy, or a speech and language therapist.

00:00:51:12 - 00:00:54:08
Once we have assessed you, and completed the investigations.

00:00:54:08 - 00:00:56:04
We will make a plan for your care.

00:00:56:04 - 00:00:58:18
Some people may be suitable for injection therapy.

00:00:58:22 - 00:01:00:21
These are called biologics.

00:01:00:21 - 00:01:03:11
They can help improve your symptoms, quality of life,

00:01:03:11 - 00:01:05:13
and reduce the amount of steroids you need.

00:01:05:13 - 00:01:08:24
They have far fewer side effects than steroids and are quite easy to take.

00:01:09:09 - 00:01:11:13
We look forward to meeting you in clinic soon.

00:01:11:13 - 00:01:14:17
Please write down any questions you may have beforehand to make sure

00:01:14:17 - 00:01:18:03
we answer them at your appointment.

What we do

Helping sufferers with this condition requires a multidisciplinary team of professionals to assist with every aspect of severe asthma care.

You might be referred for a day case assessment or a clinic review to Addenbrooke’s Hospital by your GP or your local hospital.

A day case assessment may involve seeing several members of the team.

Our team includes:

  • Severe asthma specialist nurses
  • Respiratory doctors
  • A respiratory physiotherapist
  • Lung function scientists
  • Speech and language therapists (to help with throat symptoms)
  • A dietician
  • A psychologist
  • Pharmacists
  • ENT specialists
  • Administrators
  • Respiratory research team

The medical team is led by the consultants: Dr. Robin Gore, Dr. Martin Knolle, Dr. Shuaib Nasser, Dr. Chrystalla Loutsios, Dr. Akhilesh Jha.

The nursing team is led by Caroline Owen.

The aim is to assess your condition in as much detail as possible, before deciding on treatment changes and follow-up.

You will receive a timetable prior to coming for a day case assessment and our administrator will confirm your attendance the week beforehand.

You may have to stop your inhalers before attendance. If you do, we will let you know.

Asthma and speech and language therapy video
Asthma and speech and language therapy - Video transcript

00:00:00 - 00:00:02

So your asthma consultant has referred you for speech

00:00:02 - 00:00:05

and language therapy, for upper airway assessment.

00:00:07 - 00:00:11

You may be wondering why this matters when assessing and treating your asthma.

00:00:11 - 00:00:13

Well, it's because upper airway symptoms

00:00:13 - 00:00:17

can look like chest symptoms, like a cough, breathlessness, or wheeze,

00:00:17- 00:00:19

which can complicate your asthma management.

00:00:20 - 00:00:22

So it's important that you get specialist assessment

00:00:22 - 00:00:25

to see if these problems need treating separately from your chest.

00:00:26 - 00:00:30

Common upper airway problems include feeling the throat narrowing or closing

00:00:31 - 00:00:34

lots of coughing or throat clearing, throat tightness,

00:00:35 - 00:00:39

or feeling a lump or tickle in your throat, trouble swallowing or voice problems.

00:00:40 - 00:00:42

You may find that your throat feels sensitive to certain triggers

00:00:43 - 00:00:46

such as strong smells, sudden changes in temperature, dry air,

00:00:47 - 00:00:52

exercise, or eating certain foods. So how can speech therapy help?

00:00:52 - 00:00:54

We'll explain the difference between your upper and lower

00:00:55 - 00:00:57

airway concerns, identify their causes,

00:00:57 - 00:00:59

and give you techniques to give you control.

00:01:00 - 00:01:03

We understand it can be overwhelming managing this by yourself.

00:01:04 - 00:01:08

We're here to help and look forward to seeing you at your first appointment.

Breathing Pattern Dysfunction video
Breathing Pattern Dysfunction video transcript

0:00:04 - 0:04:03

So, you have been referred to the severe asthma respiratory physiotherapist.

0:04:09 - 0:06:00

What's going to happen?

0:06:00 - 0:09:13

You may be experiencing symptoms such as a wheeze, shortness of breath

0:09:18 - 0:13:09

and persistent coughing that have a significant impact on your daily life.

0:14:01 - 0:16:12

Some people also have other symptoms such as:

0:16:12 - 0:20:09

The sensation or feeling that you cannot get enough air into your chest

0:20:09 - 0:22:24

Breathing either very fast or have shallow breaths

0:23:07 - 0:25:16

You may yawn or sigh a lot.

0:25:16 - 0:28:08

You may have chest pain or muscle tension,

0:28:08 - 0:31:08

experience dizziness or tingling hands.

0:31:08 - 0:34:17

You may not be able to coordinate your breathing whilst talking or eating,

0:35:00 - 0:38:22

or feel exhausted all the time and find it difficult to concentrate.

0:39:16 - 0:42:05

This is known as Breathing Pattern Dysfunction.

0:42:05 - 0:44:02

So, what can we do to help?

0:44:02 - 0:48:11

We will provide a thorough assessment of your symptoms and work out exactly how you breathe

0:48:11 - 0:53:00

to identify any unhelpful breathing patterns that may make your symptoms worse.

0:53:00 - 0:57:08

We will work with you to develop a personalised breathing retraining exercise program,

0:57:08 - 0:59:22

designed to help you learn to breathe more effectively,

1:00:09 - 1:02:18

so you can feel more comfortable and relaxed,

1:02:18 - 1:06:11

helping you manage breathlessness even during a flare-up of your symptoms.

1:06:23 - 1:09:24

Some people also struggle with a build-up of mucus in the lungs.

1:10:06 - 1:14:09

We can provide you with guidance on how to effectively clear the mucus from the chest

1:14:09 - 1:16:02

which will reduce coughing,

1:16:02 - 1:17:04

risk of infection

1:17:04 - 1:19:10

and improve your overall quality of life.

1:19:16 - 1:21:09

We look forward to meeting you in clinic.

Preparing for your appointment

Please bring with you a list of your medications, your inhalers, your written asthma action plan if you have one, any questions you might have and also bring the questionnaires if you have been sent some.

If you cannot attend to your appointment, please let us know at your earliest convenience so we can offer the appointment to another person.


We work closely with other severe asthma centres and the pharmaceutical industry to provide clinical trials in severe asthma. You may be asked to consider participating in a clinical trial.

Useful information for patients

Attend Anywhere video consultation

Did you know your outpatient appointment for this service may now be done by video consultation using Attend Anywhere. This enables you to be able to attend your appointment from home, saving you time and money.

Find out more about outpatient video appointments