The current treatment of asthma in the UK is rightfully seen as a triumph of chronic disease management within a primary care setting. Almost all routine asthma care and, increasingly, elements of acute asthma care, are now provided in general practice. Over the past twenty years, significant effort and investment have gone into the production and dissemination of well-respected, evidence-based asthma guidelines such as those produced by the British Thoracic Society/Scottish Intercollegiate Guideline Network (BTS/SIGN).1 Since 1990, changes to the GP contract have also served to encourage GP practices to improve the care provided to patients with asthma.