Reports reveal shocking disparities
06 May 2008

To mark World Asthma Day on 6 May 2008, Asthma UK has released a report which reveals shocking differences in the numbers of emergency hospital admissions for children with asthma across the whole of the UK. Most worryingly in England, the figures show a staggering eight-fold difference in admissions between different PCTs.

The report forms part of a campaign by Asthma UK called ‘Wish you were here?’ which highlights the lottery that children with asthma face across the UK when accessing local health services. The campaign aims to shock governments and health services across the UK into taking asthma more seriously and ensuring that consistent standards across the UK are put in place.
As well as the devastating effect on people’s lives, emergency hospital admissions are extremely costly and forms a significant part of the estimated £1 billion cost of asthma to the NHS each year.

Emergency hospital admissions for asthma for both children and adults cost the NHS £61 million per year, yet 75% of admissions are avoidable through effective asthma management and routine care. This could mean a saving of almost £46 million.

On average, a child is admitted to hospital because of their asthma every 16 minutes in the UK. Asthma UK’s report shows that in England, the region with the highest emergency admissions for children’s asthma is the North-West and the East of the England has the lowest. Topping the list for the PCT with the highest emergency admissions is Liverpool PCT, whose figures are eight times higher than those of Richmond & Twickenham PCT, with the lowest emergency admissions in the country.

The figures suggest that services for children with asthma are not of a consistently high standard across the UK, but also clearly demonstrate some link between areas of high deprivation and high emergency admissions.

Despite these figures, many PCTs and Health Boards across the UK are demonstrating an active commitment towards reducing emergency asthma admissions. For example, children’s emergency admissions in Dudley PCT in England, an area with a serious shortage of GPs, are 34% below the standardised national average. The PCT has been working with Asthma UK to help prevent unnecessary admissions by introducing a programme of training for local healthcare professionals and recruiting a dedicated asthma nurse to raise standards of asthma care and understanding in local schools.

In Scotland, Shetland Health Board has the highest emergency admissions for children, nearly three times that of Borders Health Board, which has the lowest emergency admissions.

In Wales, Swansea Health Board has the highest emergency admissions for childhood asthma, with figures more than twice as high as Ceredigion or Powys Teaching Health Boards, which have the lowest emergency admissions in Wales.

In Northern Ireland, despite a decline in emergency admissions for asthma since the 1990s, there is still a significant divide between admissions for health boards suggesting a worrying difference in the quality of asthma services. In fact, the Western Health Board’s admissions for children are more than a third higher than the Eastern Health Board, which has the lowest children’s admissions in Northern Ireland.

In light of these results, Asthma UK is calling urgently on governments across the UK to reduce unnecessary admissions for asthma among children, by ensuring children have access to high-quality asthma services wherever they live in the UK. This goal can only be achieved if all parts of the UK have consistent standards for asthma.

Currently, Northern Ireland is developing these standards in consultation with Asthma UK Northern Ireland. Scotland has standards for children and Wales has called on local health boards to develop local action plans.

Health services across the UK are being urged to help reduce emergency admissions by signing up to Asthma UK’s new Good Asthma Services Checklist, which outlines the standard of asthma services that people with the condition should be entitled to.

One of the ways they can do this is by offering every person with asthma a personal asthma action plan, as evidence suggests those with a plan are four times less likely to have an emergency admission to hospital for their asthma.

Asthma UK is also calling on parents to play their part in reducing admissions among children with asthma. Research suggests a shocking 75% of admissions could be avoided if better preventative steps were taken to manage the condition. 

Parents are therefore being urged to make sure their child has an asthma review with their GP every 6-12 months, and to prepare themselves for this review by contacting Asthma UK for their Making the most of your asthma review leaflet*, which includes key questions that parents can ask during an asthma review, and outlines what they should expect from their GP or nurse.
 
Neil Churchill, Chief Executive of Asthma UK says: ‘These figures paint a disturbing picture of the impact of asthma on children’s lives, suggesting that not all children are getting the same access to vital asthma services, such as a local specialist asthma nurse.

'These divisions are unacceptable, particularly the staggering eight-fold difference in admissions in England. If asthma is not controlled effectively, the effects can be devastating and in some cases fatal, which is why reducing the hospital admissions of people with asthma is a key aim for Asthma UK.

'Our campaign must act as a wake-up call to health services and governments about the costs and consequences of unnecessary hospital admissions.’