The new NICE guidelines for the diagnosis and management of asthma are being delayed so that implementation can be discussed with NHS England, a spokesperson has said.
The guidelines were set to be published on 31 October but have been delayed until further notice to allow for discussion about an implementation plan with NHS England.
NICE announced plans to overhaul the diagnosis process for asthma in 2015, based on concerns that misdiagnosis was a ‘significant problem’ and that diagnosis needed to be more objective.
Draft guidelines recommended forced exhaled nitric oxide (FeNO) testing and spirometry for making a diagnosis – in contrast to gold-standard BTS/SIGN guidelines, which recommend a trial of treatment.
The draft was met with fierce criticism from both the BMA and the RCGP when announced in 2015. The GP leaders criticised the guidelines for being too complex and expensive to be carried out in primary care.
The BMA expressed particular concern over the addition of FeNO testing to the diagnosis guideline as it is expensive to administer rand not routinely available in primary care.
Following criticism from the GP profession, NICE took the unprecedented step of delaying publication of the guidelines for the first time in Setpember 2015, agreeing to commission pilot studies to assess the feasibility of implementing the new tests in primary care.
The guideline was opened up for a second consultation earlier this year after it was found that the new tests were prohibitively expensive and time consuming.
When asked about the second delay, a NICE spokesperson said: ‘The guidance has been delayed to allow discussions with NHS England about an implementation plan for the guidelines.’
It comes as a study has found that using spirometry as a diagnostic test for asthma in children is ‘acceptable’ to patients and ‘helpful’ for making the clinical diagnosis of asthma.
Although not an official pilot study, the team behind the research included a member of NICE’s asthma guideline development group.
