Aims:To focus asthma care on those patients most in need whilst providing annual audit data. Methods:An observational questionnaire study. Patients on the asthma register received a postal invitation to the asthma clinic plus a questionnaire which enquired about both symptoms and the process of care. Medical records were searched for data on non-responders. Results:Of the 1241 people sent the invitation and questionnaire 682 (57%) returned it and 99 attended the clinic. Follow-up of responders with high morbidity resulted in a further 32 people attending. The 99 attenders had a higher morbidity than non-attenders on the criteria of a course of oral steroids in the last six months(15% v 29%)and a mean symptom score of 3 or more ( 12% v 31%). Conclusions:Whilst the process did focus care on those in need, and resulted in a manageable number of people attending the asthma clinic, many individuals with high morbidity or risk factors did not attend.