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Medical management of asthma focuses on drugs which, although effective, are costly and produce side-effects. Recent evidence suggests a role for breathing interventions that reduce total ventilation, such as the Buteyko method, which has strong similarities to techniques already used by therapists to manage hyperventilation. Both approaches should be made readily available to patients with asthma. Asthma nurses and therapists should consider these techniques to enable patients to ‘step down’ drug treatments in accordance with medical guidelines. This may involve a re-thinking of their role, from one where the main emphasis is on supporting the established medical model towards one that also offers a non-pharmacological alternative. This article explains the aims of Buteyko and discusses the increasing evidence base for methods that reduce ventilation and may benefit many patients with asthma, not just those with established chronic hyperventilation.

The NHS aspires towards 7-day working for allied health professionals (Department of Health (DoH), 2000a). However, insufficient staff numbers and years of inadequate investment look likely to prevent this from becoming a reality in the medium term. Yet services need to deliver much-needed improved access to care, reduced length of stay and prevention of admission to offset the capacity issues faced by the majority of NHS trusts. Weekend and evening overtime rotas are seen by many trusts as a stop-gap measure to address the above issues. However, unlike appropriately funded 7-day working, the issues of access to senior opinion and the development and maintenance of competence in this situation are much less clear.