More than 12,000 people in the UK have died from asthma attacks since a landmark report a decade ago, and asthma care is now “in crisis”, a charity has warned.
The analysis by Asthma + Lung UK has shown that, 10 years on from the National Review of Asthma Deaths, the annual death toll has risen by a quarter and, it has argued, complacency around asthma has led to thousands of preventable deaths.
People with asthma are being failed, with seven out of 10 not receiving basic life-saving asthma care, the charity has said, while calling for urgent government action to end preventable asthma deaths.
Four people die from asthma every day and many more continue to be at risk, with tens of thousands admitted to hospital for life-threatening asthma attacks each year, it said.
It is calling on the government to introduce national targets to end preventable asthma deaths.
The charity has also urged minister to dedicate sufficient funding to implement the upcoming asthma guidelines from the National Institute for Health and Care Excellence to ensure that everyone with the condition receives vital basic care.
Asthma care
Being poor doubles risk of emergency asthma hospital admission
Investment in technology is also essential for the transformation of asthma management, helping people to manage their condition and recognise warning signs, especially those who are less engaged with healthcare services, it has said.
The National Review of Asthma Deaths: Why asthma still kills (NRAD) was published by the Royal College of Physicians in 2014 and found that two-thirds of asthma deaths were preventable.
Key risk factors for death from asthma included overuse of reliever inhalers indicating poorly controlled asthma, underuse of preventer inhalers and recent emergency hospital visits with no follow-up.
But in the decade since that report’s publication, the analysis by Asthma + Lung UK has shown that “shockingly little” has changed for the 5.4 million people in the UK living with asthma.
The charity has pointed to a lack of political will to implement NRAD’s recommendations and complacency around the condition, arguing that as a result “asthma care is at a standstill”.
A decade on, NRAD’s recommendations have not been routinely implemented. While there are some areas of good practice, asthma care still varies widely across regions, with many not receiving the care they need, it argued.
Lack of basic asthma care
Almost seven out of ten (69%) people surveyed are not receiving basic asthma care as recommended by the report. This should include annual asthma reviews, inhaler technique checks, and written asthma action plans, all of which enable healthcare professionals to support people with asthma so they are doing the right things to keep their asthma under control.
Overuse of reliever inhalers was highlighted in the report as key indicator of poorly controlled asthma which puts people at greater risk of death. Yet behavioural insight work by Asthma + Lung UK showed that, worryingly, nearly a third (31%) of people surveyed rely on reliever inhaler to manage their condition.
Additionally, follow-up care is woefully inadequate, with a study showing that 82% are not getting an appointment with a GP or asthma nurse within the recommended 48 hours after an emergency admission, when they are most at risk of another serious attack. Furthermore, two in five (40%) people who ended up in hospital did not have a follow-up within 28 days.
Problem we can fix
Sarah MacFadyen, head of policy and external affairs for Asthma + Lung UK, said: “It’s scandalous that 10 years on from NRAD’s recommendations to improve asthma care, four people are still dying needlessly from the condition every day.
“Asthma care is in crisis. People are not getting the care they need and deserve. As a result the UK continues to have one of the worst asthma death rates in Europe. We don’t want to be saying the same thing in another ten years; this is a problem we know how to fix.
“With better care and support, people with asthma could manage their condition well and avoid life-threatening asthma attacks, while investment in research and innovation to develop technology to help people self-manage their asthma, could also be transformative like it has for conditions like diabetes. Not only will these changes save lives and improve people’s health and quality of life, it will also reduce the impact of poorly controlled asthma on health services and help the NHS.”
Dr John Dean, clinical vice president at the Royal College of Physicians, said: “A decade ago, RCP’s report provided a clear blueprint for improvement from leaders in asthma care.
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“Sadly, NHS care in urgent and emergency care, planned specialist care and primary and community care are unable to deliver the care they know people with asthma need. This is unacceptable. Each of these elements needs redesign, and integration to move with patients to a preventive approach, rather than just treating emergencies. This needs political will, and a workforce to deliver it. Clinical leaders are ready to lead that change,” he added.
