FeNO Testing

Despite some of the lowest air quality and highest levels of urbanisation, London consistently diagnosed COPD and Asthma below the national average. ​​Therefore, there’s a requirement to rethink and redevelop how we diagnose and treat Asthma in our area. the FeNO programme supports identification at an early stage. 

Our work on FeNO

At Imperial College Health Partners we have been working with the AHSN Network, Wessex AHSN and NHS England’s AAC, to support faster and more effective Asthma diagnosis via Fractional exhaled Nitric Oxide (FeNo) testing. 

FeNO testing is a simple, non-invasive test to measure the amount of nitric oxide in an exhaled breath – a biomarker for airway inflammation. FeNO testing can improve patient care by contributing to a faster and more effective asthma diagnosis when used alongside a detailed clinical history and other tests. It can also be used to monitor patient response to asthma treatments. 

The aim of the FeNO Rapid Uptake Product (RUP) programme is to:

  • Improve patient care and outcomes by more effectively diagnosing patients with suspected asthma
  • Increase widespread patient and clinician access to FeNO testing across primary care



Our support for NWL focused on: 


Improved Access

Introduced 16 Respiratory Diagonistic Hublets (RDHs) to NWL across 8, each providing FeNo testing.


1,576 patients had recieved a FeNO test across NWL (figures to end of Jan 2023), exceeding our target by over 100%.

Improving Quality of Diagnosis

Working towards introducing and embedding a quality-assured assessment to inform quality diagnosis of COPD and asthma, through work with primary care stakeholders, facilitation of training and ARTP accreditation, and strong leadership & coordination at the ICS level.

Improved Reporting

Worked collaboratively across the system to implement monthly reporting at ICS level, reported into NWL Respiratory Clinical Reference Group. 

Explore our FeNO resources


Learn more in the FeNO toolkit

Coming soon: Watch our FeNO outcomes webinar

The AAC programme added much value to the development of respiratory hubs in NWL; we were able to accelerate our model beyond spirometry to include FeNO at low risk to the hubs. Hubs are now fully utilising the machines, and quality assured diagnosis of asthma is increasing each quarter as more appointments are offered. Resources to allow existing programmes of work to move faster are always more easily embedded into business as usual and garner good system engagement, as we’ve seen from this QI project.

Gemma SquelchTransformation Programme Manager - Primary, Social and Community Care, NHS North West London

Want to find out more about the our work in FeNO?

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