Severe asthma is a complex chronic disease underpinned by several phenotypes and various comorbidities and risk factors. It affects a relatively small number of people but represents a heavy burden for individuals and the healthcare system. Recently, biologics have started to be used to treat severe asthma and have the potential to transform patients’ lives by reducing symptoms, exacerbations and reliance on oral corticosteroids. This article explains how to identify patients with poorly controlled asthma and describes the role of specialist asthma centres and severe asthma multidisciplinary teams in England. The authors also describe how a project in south west England made it possible to increase eligible patients’ access to treatment with biologics, through collaborative working between the South West Severe Asthma Network, acute trusts and severe asthma centres.