A concise guide to the BTS/NICE/SIGN joint guideline on chronic asthma, what it includes, what it excludes, and where clinicians and patients can find supporting resources and contacts
The British Thoracic Society (BTS), the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) collaborated to publish a combined clinical guideline on the diagnosis, monitoring and management of chronic asthma. The guideline was released on 1 November 2026 and represents a harmonised set of recommendations intended for use by clinicians, allied health professionals and service planners.
A dedicated session presenting the guideline was held at the BTS Winter Meeting on 28 November 2026, and a recording of that presentation is available for those who could not attend.
This document focuses specifically on long-term care rather than emergency management: it aims to improve the accuracy of diagnosis, support better day-to-day control and reduce the risk of future exacerbations.
It deliberately does not replace separate guidance on severe asthma or on acute asthma attacks, which are addressed through the related asthma pathway materials. The guideline also serves as a foundation for local implementation and the development of tools and quality standards across the UK health services.
What the guideline covers
The joint guideline provides consolidated recommendations on the processes and clinical steps for identifying and following people with asthma of varying ages. It addresses key domains including assessment strategies to refine diagnosis, approaches to ongoing monitoring such as symptom review and objective lung function testing, and frameworks for adjusting treatment as part of routine care. Children, young people and adults are covered, with age-appropriate considerations woven into the recommendations. The text also highlights the importance of personalised care planning, inhaler technique checks and adherence support as central components of effective chronic asthma management.
How clinicians and services should use the pathway
The guideline is intended to be operational: teams can use it to standardise assessments, reduce diagnostic uncertainty and align treatment decisions with evidence-based thresholds. The companion Joint Asthma Pathway aggregates the key recommendations and points users to practical resources. For frontline staff the pathway acts as a quick-reference map that signposts protocols, decision points and escalation routes. Service leaders can use the guidance to structure audits, training and quality improvement programmes aimed at reducing preventable attacks and optimising control for people living with asthma.
Resources and linked tools
Two central online resources complement the guideline: the Asthma Pathway: NICE and the Asthma Pathway: Health Improvement Scotland pages. These platforms host flowcharts, patient information templates and links to education materials that support implementation. The pathway materials also clarify which topics are out of scope for the guideline — notably management of severe asthma and acute emergency care — and direct readers to the appropriate specialist recommendations and protocols for those contexts.
Contacts and further enquiries
For questions about the joint guideline or for clarification on implementation, the guideline authors invited correspondence to a central contact point: [email protected]. Clinicians, service managers and stakeholders are encouraged to use that contact to request guidance on local adaptation, to report implementation challenges or to seek further educational materials. Engagement with local professional networks and regional respiratory teams is also recommended to ensure consistent application of the recommendations.
Context, exclusions and next steps
The joint publication by BTS, NICE and SIGN reflects a coordinated effort to reduce variation in asthma care across the UK. While it centralises many core recommendations, it does not replace condition-specific pathways for complex cases: management of severe asthma and handling of acute asthma attacks remain covered by separate guidance and pathway documents. Organisations implementing the guideline should therefore plan for clear referral pathways, training on the pathway components and ongoing audit to measure impact and safety.
Clinics and teams that wish to embed the guideline can begin by reviewing the Joint Asthma Pathway resources, updating local protocols to reflect the new recommendations and arranging multidisciplinary training sessions. Stakeholders who want to explore the guideline in depth or access the BTS Winter Meeting session recording should consult the hosting organisations’ websites or contact the address provided above for further directions and materials.
