Development and National Implementation of a Standardized Physiotherapy Assessment Package for Pediatric Asthma and Dysfunctional Breathing.

INTRODUCTION

Variation in pediatric respiratory physiotherapy assessment for asthma and dysfunctional breathing (DB) across NHS services creates inconsistency in clinical reasoning, workforce development, and data harmonization. We aimed to design and implement a standardized, evidence-informed assessment package to support physiotherapists working with children and young people (CYP) with asthma and DB.

METHODS

Evidence from a previously conducted structured scoping review (PROSPERO ID: 112227) informed key assessment domains. A national collaborative of specialist pediatric respiratory physiotherapists (Kids' Cornerstone Collaborative) co-developed a standardized assessment proforma, competency framework (Agenda for Change Band 5-8), and supporting educational materials. An iterative, problem-driven implementation approach was piloted across five NHS sites and refined using a Theory of Change framework. National dissemination occurred via professional networks and conferences. Uptake was assessed through formal access requests and user agreements.

RESULTS

The final package included a standardized pediatric asthma and DB assessment proforma (digital and paper formats), an implementation playbook, competency framework, and educational resources. Intellectual property agreements enabled free NHS national adoption. Fifty-six NHS Trusts across all UK regions requested access; 30 completed user agreements and received the full package. Pilot implementation informed iterative refinement and strengthened the national collaborative infrastructure.

CONCLUSION

We developed and nationally disseminated a standardized physiotherapy assessment package for CYP with asthma and/or DB, achieving broad professional engagement across the United KIngdom. This initiative supports consistent evidence-based clinical practice, structured competency development, and future harmonized outcome evaluation across NHS services.