ABSTRACT
It is essential that the use of self-management plans within the context of shared care is based upon a full accord between patients and the primary and secondary care clinicians. The requirement is that patients should change their behaviour in response to changes in the severity of their disease and this should be an essential component of the knowledge that is imparted to patients in regard to their asthma. The consequence for patients of repeated assessment of health status as satisfactory should lead to transfer of care from the secondary to the primary sector. If the patient's state of health remains satisfactory, especially after a number of clinical assessments, then a number of options are open to the patient and physician. It is possible for a patient to feel ill and for the general practitioner to be unable to find a cause but for the health status of the patient to be labelled as 'unsatisfactory'.
