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GPs buried under trusts' workload dump

Asthma deaths highest in a decade

Deaths from asthma have reached their highest level for a decade, new findings have revealed.

The number of deaths has increased by over a third, according to the latest analysis of ONS data, and the RCGP and Asthma UK are calling for greater provision of support for those with the respiratory condition.

Over 1,400 people died of an asthma attack last year, up 8% from 2017, while the data also shows marked increases in deaths among men and the 35- to 44-year-old demographic.

Geographical trends were also observed, with a 25% rise in those dying of asthma in the South East. Additionally, London experienced a 17% surge between 2017 and 2018.

Last year saw record numbers of asthma deaths, but this year's total has surpassed it. 

The National Review of Asthma Deaths, commissioned by the NHS and Department of Health and Social Care in 2014, claimed that two thirds of asthma deaths could be preventable if basic care improved. However, only one of the 19 recommendations has been partially implemented.

Kay Boycott, chief executive of Asthma UK, said: ‘The same mistakes are being made again and again because essential recommendations have not been implemented. This lack of action is costing lives and devastating families and communities.

‘The NHS needs to ensure that all healthcare professionals are providing this care to patients.’

RCGP chair Professor Helen Stokes-Lampard agreed that addressing the issue should be prioritised by the NHS, as well as the Government.

She added: ‘Asthma is a common condition in general practice and GPs and their nursing teams understand the importance of carefully managing patients with asthma, including through the use of personal asthma action plans, as well as encouraging patients to undergo regular reviews.

‘It is also vitally important that patients understand their own treatment and how to properly use equipment, such as inhalers, peak flow meters, and spacer devices - and GPs and our teams play an important role in ensuring patients of all ages feel more confident about managing their asthma appropriately and effectively.'

This month, NICE published new indicators, which could be adopted into next year’s QOF framework to improve asthma misdiagnosis and overtreatment. 

Asthma also peaks around the back-to-school period in September, with the Journal of Epidemiology and Community Health recently claiming that this was a reason behind the increase in GP appointments across England. 

Readers' comments (3)

  • the actual numbers would go up as we have a bigger population. Most of the deaths are in the very elderly so not really sure why this is an issue. recording of asthma in the elderly with copd attracts more qof payments rather than just coding for one or the other. As practices introduced spirometry in the 2000s its not surprising there is more coding for asthma.
    It is interesting that deaths were dropping after the introduction of QOF and spirometry into general practice and the introduction of new inhalers such as lamas and montelukast but this has gone backwards since 2008 - the time of the financial crash - followed by over 10 years of chronic underfunding of the NHS and loss of staff. this is also combined with poverty, use of food banks and poorer diets and removal of local transport causing more car use and hence road pollution, such that levels are regularly at unsafe levels, even in less urban levels. 5% of all lung cancer worldwide is due to pollution. If this amount of pollution is damaging lungs to cause cancer its not surprising their is now more asthma in the UK and elsewhere in the world.
    So you have a multi factorial issue which cannot be solved by blaming one thing in particular.
    Changing QOF is pointless if you don't have the trained staff in the first place. Considering primary care is becoming more on line and these patients are less likely to see a doctor or having staff to listen to their chest the prognosis for asthma detection is going to be poor. Not listening to patients chests also misses heart valve problems and CCF which i commonly pick as causes of wheeze and sob and are regularly missed. Having today recoded a patient from supposedly having asthma despite normal spirometry to bronchiectasis and emphysema confirmed on a cat scan - to actually make such diagnoses are not that easy and takes years of experience which is certainly not reflected in the QOF payments for the time involved. To do the job effectively takes training, mentoring and having adequate resources to do the job including longer appointments. But if pollution levels increase, as they are, i can prescribe all the inhalers in the world and it will not much make that much difference unless we change our own behaviour as a population. I suggest pollution masks to my own patients to protect their lungs especially if they cycle in traffic on a regular basis. I find it really sad that i have to advise this in the UK now.

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  • Another GPs must do better story

    Add it to the list

    Load of cock and balls

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  • In the 2019/20 QOF there are 20 points available for carrying out an annual review on all the people with asthma on your list. That’s about £5:00 a head. Let’s be realistic about how much nurse and doctor time this buys after tax, pension, utilities, use of facilities, and admin time to arrange the appointment. Not enough to buy a coffee,

    Add to this all the other pressures and demands so eloquently explored on these pages, and the constant pressure from CCGs to deprescribe expensive inhalers and therapies. Throw in some perverse incentives to increase coding of asthma, Chuck in some pollution and clouds of vape smoke and you’re done.

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