Asthma Guidelines UK: BTS, NICE & SIGN Unite on Diagnosis and Management Standards

young woman coughing with fist

Asthma affects over 5 million people across the UK. Whether you're living with asthma, treating patients, or simply want to stay updated, the new asthma guidelines UK offer a big shift in how we approach diagnosis and long-term management. For the first time, the British Thoracic Society (BTS), NICE, and the Scottish Intercollegiate Guidelines Network (SIGN) have created a single, clear set of asthma clinical guidelines.

Let us walk you through the most important points from the updated BTS and SIGN asthma guidelines, how they can help patients and healthcare professionals, and what it means for asthma care moving forward.

What Are the New UK Asthma Guidelines All About?

The BTS, NICE and SIGN asthma guidelines were published on 27 November 2024 and represent the first-ever UK-wide joint guidance for asthma. This comprehensive document covers everything from how asthma is diagnosed to how it's monitored and managed over time.

Importantly, the guideline:

  • Replaces older guidance like NICE guideline 80 and parts of SIGN 158
  • Brings together the best practice in one place
  • Introduces major changes to first-line treatment for chronic asthma

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Key Changes in Asthma Diagnosis and Monitoring

Objective Testing First

The new asthma diagnosis guidelines put a firm emphasis on objective testing when someone first presents with symptoms. This includes:

  • FeNO testing (a simple breath test)
  • Spirometry and peak flow measurements
  • Blood tests for eosinophils

These changes aim to improve diagnostic accuracy and reduce misdiagnosis.

No More "Blue Inhaler Only" Approach

One of the most notable changes in the asthma management guidelines is around initial treatment. The traditional use of the blue short-acting beta2 agonist (SABA) inhaler alone is no longer recommended. Instead:

People aged 12 and over with newly diagnosed asthma should be offered a low-dose combination inhaler (inhaled corticosteroids and formoterol) to be used as needed.

This helps control inflammation early and reduces the risk of severe attacks.

A New Digital Asthma Pathway for Clinicians

The joint guideline also introduces a digital asthma pathway – a handy online tool bringing together everything from diagnostic tests to treatment plans. It includes:

  • Acute asthma management
  • Occupational asthma support
  • Non-drug management tips
  • Climate-conscious inhaler decision aids

This central resource is available from the BTS, NICE, and SIGN websites to help healthcare providers give consistent, high-quality care.

For allergy-related triggers, consider reading our guide on allergy testing services.

Why These Guidelines Matter

Asthma is more than wheezing and breathlessness. Poorly managed asthma can lead to life-threatening attacks and frequent hospital visits. The new NICE asthma guidelines aim to:

  • Standardise asthma care across the UK
  • Simplify the diagnostic process
  • Promote more effective, evidence-based treatments
  • Reduce hospital admissions

As Dr Paul Walker of the BTS puts it, these changes "represent a true pivot in the principles of asthma care."

Who Should Pay Attention to These Guidelines?

The new asthma guidelines UK are intended for:

  • GPs, nurses, and asthma specialists
  • Clinical commissioners and providers
  • People with asthma and their families

Whether you're a healthcare professional or someone managing asthma day-to-day, these guidelines can help you make informed decisions and feel more in control.

To book an asthma review or respiratory consultation, please contact our team.

FAQs About Asthma Guidelines

What are asthma clinical guidelines?

Asthma clinical guidelines are evidence-based recommendations that guide healthcare professionals on the best ways to diagnose, treat, and monitor asthma.

Who developed the latest UK asthma guidelines?

The 2024 guidelines were jointly developed by the British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE), and Scottish Intercollegiate Guidelines Network (SIGN).

What has changed in the BTS asthma guidelines?

The key change is the recommendation to avoid blue inhaler-only treatment. Instead, a low-dose corticosteroid and formoterol inhaler is now preferred from the point of diagnosis.

Are the NICE guidelines asthma-specific?

Yes, NICE has worked alongside BTS and SIGN to create asthma-specific guidance that covers both diagnosis and long-term management.

Where can I read the full asthma guidelines?

You can access the full guideline and resources on the NICE website or through the BTS and SIGN portals.

Final Thoughts

This unified set of asthma guidelines UK is a major step forward in respiratory care. It puts accurate diagnosis and effective treatment front and centre, helping both patients and professionals work together to better manage asthma. If you or someone you know has asthma, speak to your GP or nurse about how these changes might affect your treatment.

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Dr Ibrahim Mutlib

Dr. Ibrahim Mutlib (BMBS, BMedSci) is an experienced GP with specialist interests in mental health, gastrointestinal health, and respiratory medicine. A clinical leader and published author, he is passionate about innovative, patient-centred care that supports both physical and emotional wellbeing.

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