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Key asthma spend drives hospital cuts

By Lilian Anekwe

New NHS data has linked low PCT spending on asthma with poor patient outcomes and highlighted areas where GP commissioners will have to invest in reduce hospital admissions and lengths of stay.

For the first time a national balanced scorecard of NHS figures has ranked PCTs on their spend on asthma care, allowing the investment to be related to outcomes including hospital admissions, readmissions and length of stay.

There was more than a tenfold variation between the highest spenders on asthma care. NHS South Tyneside spent just under £2.4 million per 100,000 of the population, and the lowest spender, NHS Waltham Forest who spent just £214,000.

Of the 40 PCTs with significantly higher emergency asthma admissions than expected, only 10% were also among the highest spenders on asthma per 100,000.

Of the lower spenders, NHS Ealing spent £1.5 million per 100,000 of the population on asthma but had adult admissions 54% higher than expected. Admissions in deprived groups were 68% above that predicted for a population of its size.

NHS Bournemouth and Poole spent £1.6 million per 100,000 on asthma, but was in the third of PCTs with the longest length of stay for emergency admissions, with a median of three days, and 18% more readmissions than predicted for a PCT its size.

A spokesperson for NHS Ealing said the Trust 'recgonised it had higher ratios for hospital admissions' and had hired a specialist asthma nurse to address this. NHS Bournemouth and Poole was unavailable for comment.

The report, compiled by Asthma UK, called on GPs to use the data to inform their future commissioning decisions.

Dr Mike Thomas, a GP in Minchinhampton, Gloucestershire and chief medical advisor to Asthma UK said: ‘This is a really interesting resource for GPs. It highlights variation in a range of indicators and outcomes to give a great overview of how asthma indicators in their area compare with regional and national figures.

‘Looking into these figures will help GP commissioners to identify and tackle possible problems with local services - such as high readmission rates coupled with short lengths of stay, which may be a sign that people with asthma are being discharged too early.'

The data, along with a guide for GPs on commissioning good asthma care, is available from Asthma UK.

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