Fractional exhaled Nitric Oxide (FeNO) testing

FeNO is a non-invasive test to measure the amount of nitric oxide in an exhaled breath, a biomarker for airway inflammation. It contributes to faster, and more effective asthma diagnosis and can monitor patient response to asthma treatments.

Between April 2021 and February 2023, 51 devices were spread across Kent, Surrey and Sussex benefitting c. 4,000 patients and preventing 1,450 false positive diagnoses – an equivalent saving of £420,380 a year.

Find out more in the impact reporting.

COPD discharge bundle

In 2014 it was recognised that there was room for improvement in the care of hospitalised COPD patients. Kent Surrey Sussex Respiratory Network agreed to deliver a discharge bundle to reduce variation and improve care on discharge. KSS acute trusts agreed to measure and benchmark their success at applying the COPD bundle by reporting trust performance on providing five key quality measures to patients:

  1. Inhaler technique assessed and corrected
  2. Patient or carer has written information & understands their self management plan
  3. Provision of rescue packs
  4. Smokers referred to smoking cessation
  5. Assessment for enrolment in pulmonary rehabilitation (PR)
  6. Appropriate follow-up arranged

In order to provide more insight there are a number of follow-up questions including:

  • What was the result of the inhaler technique assessment?
  • What type of documentation was the patient given?
  • Was the patient referred to Pulmonary Rehabilitation?
  • What type of follow up was arranged?

Starting from October 2014 discharges, trusts have been encouraged to submit data on a monthly basis. The patient population for the bundle is those patients over 35 years old, discharged with a primary COPD code (J41, J42, J43, J44).

Pulmonary rehabilitation

​The South East (Kent Surrey Sussex) Clinical Network and KSS Respiratory Network (hosted by Health Innovation KSS) are delighted to be working in partnership to support Pulmonary Rehabilitation (PR) providers across Kent, Surrey and Sussex with a regional approach to obtaining PR Service Accreditation (PRSAS) from the Royal College of Physicians.

The NHS Long Term Plan has provided a focus on improving uptake to Pulmonary Rehabilitation services and enabling services to demonstrate the quality of service provision with the expectation that demonstration of competence/accreditation of services will become a mandated requirement in the future.

Through this partnership, South East Clinical Network and Health Innovation KSS will fund each participating PR Service’s first annual PRSAS subscription fee, as well as provide continuous peer support through the KSS PR Clinical Network, to support services to work towards accreditation achievement. A regional PR dashboard will also be developed to facilitate quality improvement.

Non-invasive ventilation

Clinicians from Kent, Surrey and Sussex have written the modules for the national Acute NIV e-learning programme. They include:

  1. Introduction to Ventilation
  2. Selection of Patients for NIV: Indications and Considerations
  3. Set Up
  4. Monitoring
  5. Acute Non-invasive Ventilation Ongoing Management and Escalation
  6. Difficult Decisions.
Clinical Networks
OXYGEN and respiratory failure CLINICAL NETWORK

The Kent Surrey Sussex Oxygen and Respiratory Failure Clinical Network brings together clinicians involved in home oxygen services, mainly specialist nurses and physiotherapists. The network aims to improve the quality and safety, and cost-effectiveness of oxygen services in the region.

The network offers education, updates on national guidance and standards, contracting and supplier issues, and facilitates collaborative work, such as reaching regionally agreed pathways and protocols.




The Kent Surrey Sussex Pulmonary Rehabilitation (PR) Network brings together clinicians, including specialist physiotherapists, nurses, occupational therapists and therapy assistants, to improve the quality and safety of PR services in the region.

The network offers education, updates on e.g. national guidance and standards, and facilitates collaborative work (e.g. benchmarking).