Recipient organisationNHS Kent and Medway Integrated Care Board (qks)
Funding£248K
PeriodJun 2025 — Nov 2026
In plain English
AI plain-English summary
Asthma patients in deprived areas may not benefit equally from a proven self-management programme, and this project will find out why. The IMP2ART programme already helps GP practices teach patients to manage their asthma—reducing attacks and hospital visits. But early signs suggest that practices serving poorer or more diverse communities struggle to implement it, risking widening health inequalities. This project digs into that gap. Researchers will analyse cost-effectiveness across different patient groups, interview clinicians and patients from under-served practices, and bring stakeholders together to identify what goes wrong and how to fix it. If successful, the findings will give policymakers and GP practices a practical playbook for rolling out asthma self-management fairly—not just where it is easiest. That could mean fewer emergency admissions for asthma in deprived areas, and a healthcare system that does not quietly leave some patients behind. The work directly supports national efforts to tackle health inequalities, turning a well-evidenced treatment into one that works for everyone, not just the well-served.
View original technical description
Development work questions Does facilitating the implementation of supported self-management (SSM) in primary care practices risk exacerbating inequities and, if so, how can facilitation and other strategies be adapted to promote implementation of SSM in under-served groups? Background The evidence that SSM improves asthma outcomes in diverse clinical and socioeconomic contexts is overwhelming . IMP2ART (IMPlementing IMProved Asthma self-management as Routine) is conducting a UK-wide cluster randomised implementation trial (completion September 2025) testing a whole systems approach to embedding SSM in 144 general practices. Recruited practices are distributed across the spectrum of deprivation, rurality and ethnic minority populations. Within these practices, routinely collected anonymised primary care data on all registered patients with active asthma will be extracted to determine clinical, implementation and cost outcomes. Trial analyses will address overall cost/effectiveness, but it's likely that the impact of IMP2ART will vary between and within practices. The IMP2ART facilitators (who worked with practices to embed IMP2ART strategies) observed that clinicians working with underserved communities often struggled to implement change raising concerns about exacerbating health inequalities; though conversely, with targeted support they may have more to gain. The IMP2ART PDG on equity (PDG-E) will explore these challenges and recommend strategies to reducing this risk. Aim and objectives We aim to explore the potentially inequitable delivery of IMP2ART in more depth than is possible within the Programme Grant, with the goal of informing equitable provision of SSM for people with asthma in primary care. Objectives are to: Identify, from the IMP2ART data and discussions with stakeholders, the groups at particular risk of inequitable implementation of SSM Conduct a distributional cost-effectiveness analysis (DCEA) to explore distribution of costs and effects within the identified groups Explore professional and patient perspectives on equitable implementation of SSM in the identified groups Triangulate our findings to inform recommendations for the future sustainable, equitable dissemination and implementation of IMP2ART Proposed work Aligned with our four objectives, we'll: PDG-E1: Invite PPI and professional stakeholders from a representative sample of IMP2ART practices to an on-line workshop to advise on equity challenges that we should consider in PDGs-E2&3. PDG-E2: Conduct a DCEA through extending the IMP2ART economic evaluation framework to examine the distribution of costs and effects across identified groups from PDG-E1 and report findings in an online workshop. PDG- E3: Interview a purposive sample of stakeholders (professionals, managers, patients) from diverse IMP2ART practices, to explore their perspectives/experiences of equity challenges. Thematic analysis will be informed by PDGs-E1&E2 and findings reported in the online workshop. PDG- E4: Triangulate, in discussion with stakeholders, findings from PDGs-E1-3 to identify key components and potential trade-offs to inform equitable implementation of SSM in under-served groups. Timelines PDGs-E1&2 will be alongside the final 6-months of IMP2ART, completing DCEA analysis by 9-months. PDG- E3 will follow (months 5-13), with months 14-18 for PDG-E4 and reporting. Anticipated impact Aligned with national public health agendas to tackle health inequalities, our evaluation of equity, alongside the IMP2ART programme will inform policymakers seeking to implement SSM for the benefit of all people with asthma.
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