POAC Funding of Acute Asthma
Eligibility Criteria
To qualify for POAC funding:
Community Management: The patient must be safely manageable within the community.
Initial Therapy Trial: The patient should have undergone an initial trial of therapy.
Admission Avoidance: The patient would otherwise be referred to hospital
Patient safety is paramount and non-negotiable. Any management plan must prioritise the well-being and safety of the patient.
Acute Asthma in Adults
In general, the initial management of Acute Asthma in an adult can be safely undertaken in a community setting (GP/UCC). A case becomes eligible for POAC funding only where patient fails to respond to initial trial of therapy.
Initial Therapy Trial: The patient should have undergone an initial trial of therapy, which includes:
A comprehensive clinical assessment.
Administration of two nebuliser or spacer therapies, spaced 10–15 minutes apart.
Oral prednisone, if indicated.
Assessment Post-Therapy: Evaluate the patient's PEFR or FEV1 15 minutes after the initial therapy:
< 33% of Predicted/Best: Not eligible for POAC funding; immediate hospital referral recommended.
33–70% of Predicted/Best: Eligible for POAC funding (post initial therapy)
> 70% of Predicted/Best: Not eligible for POAC funding; manageable as routine primary care.
Ensure to provide records of respiratory distress levels, respiratory rate, pulse rate, and PEFR or FEV1 at initial presentation and each subsequent intervention. Please also include the patient's predicted or best PEFR.
Acute Asthma in Children
POAC provides funding of Acute Asthma management in Children under following circumstances:
Moderately severe, as defined by HealthPathway
An initial trial of therapy has failed, and the patient remains moderate severity. Plan to repeat salbutamol 100 micrograms, 6 puffs via MDI with spacer every 20 minutes over the first hour.
POAC will fund observation for up to 1 hour from the time of second trial of therapy.
POAC Funding Information
Submitting Claim:
Submit a new POAC referral using diagnosis code 'Asthma' (this should be submitted at the time of treatment)
Submit invoice for services provided, ensuring full clinical documentation is included.
Observation time (post initial therapy) and a clinical review (where clinically indicated) may be claimed
Refer POAC Claiming Guide for further information
Exceptional Circumstances:
In rare cases where a patient falls outside the standard eligibility criteria:
Approval must be obtained from the Clinical Director, or
Comprehensive clinical information must be provided to the Clinical Governance Committee to confirm that:
A hospital referral was indicated.
Patient safety was not compromised.