Asthma is a very common condition amongst adolescents, affecting quality of life, school attendance and ability to participate in physical activities. The current emphasis is on providing structured care through general practice, and this may be beneficial for those who attend. Adolescents rarely attend general practice, and in a recent survey many were critical of primary care. There is a need to explore alternative models of provision of asthma care for this age-group. This study will establish asthma clinics in four comprehensive schools, led by school nurses but working with local GPs. The clinics will form part of a comprehensive asthma policy for these schools.

The schools asthma clinics will be evaluated through a pragmatic randomised controlled trial, in which half of the pupils with asthma in school years 7 to 11 will be invited to attend the clinic. The reminder will be invited to attend their practice for usual GP/practice nurse care. Outcomes will include whether patients’ asthma has been reviewed, morbidity, quality of life, understanding, appropriate treatment, health service utilisation and costs. Because of the likelihood that the existence of the schools clinic and the schools asthma policy will have an affect on pupils not invited to the clinic, a further observational comparison will be made with pupils at two schools with no intervention.