Asthma presents a continuing challenge across primary care and research has shown that despite best efforts the numbers of patients who require optimisation and access to advanced therapies remains high. The Liverpool Severe Asthma Service (LSAS), which covers Cheshire and Merseyside, has been accelerating access to specialist care for asthma patients through innovative pathway transformation work. A campaign is now underway to encourage early referral to specialist asthma services, for patients at risk of having severe asthma. Nigel Thompson reports: