More than 2.5 million people with asthma in England look set to enter the most difficult winter for decades with uncontrolled symptoms, likely exacerbated by lack of access to basic care and annual asthma reviews during the pandemic.
Results of a survey conducted by Asthma UK revealed that over half (58%) of respondents said their asthma self-management was deteriorating and they are using their reliever inhaler three or more times a week.1
Using a reliever inhaler three times a week or more is a red flag that a person’s symptoms are getting worse and they are at an increased risk of an asthma attack. Every day in the UK, an average of three people die from an asthma attack.2
Asthma UK is now issuing an urgent call to anyone who is using their reliever inhaler three times a week or more to book an appointment with their GP as soon as they can, which might be offered over telephone or video call.
Sarah Green from Birmingham knows only too well how important it is to seek help if your asthma is getting worse. Her daughter Holly was using her reliever inhaler every day before she died from an asthma attack in 2016 at just 28-years-old.
Sarah said: “When I look back on the months leading to up Holly’s death, all the signs were there that she was really struggling with her asthma. I’d become used to seeing her puff on her blue inhaler every day and she was going through them really quickly. She had an asthma attack suddenly one evening and she was gone forever.
“Holly was a busy mum of two young boys and was more focused on looking after them than taking care of her own health.
“I’d say to anyone with asthma, please do everything you can to look after yourself this winter. I didn’t realise how serious asthma could be until it took Holly away from me and left her twin boys without their mother.”
Winter is the deadliest season for people with respiratory conditions, as cold weather, flu, common colds and chest infections are all triggers for asthma. This year, the challenge is greater than it’s ever been with the COVID-19 pandemic, so it’s vital that people manage their asthma well so they can stay fit and better able to cope with a respiratory virus if they catch one.
There could be many reasons why a person’s asthma is getting worse, but Asthma UK is highly concerned by data which shows that many people are struggling to, or are reluctant to, access their basic asthma care.
A separate survey carried out by the charity found that 25% of people with asthma have delayed or avoided care since the start of July through fear of being a burden during a busy time or because of concerns about the spread of COVID-19 in health care settings.3
More than a fifth (22%) of people with asthma have had their regular care cancelled by their GP practice. This includes an annual asthma review, where patients have their inhaler technique checked and are provided with an up-to-date asthma action plan.4 An asthma action plan states which medicines you take every day to prevent symptoms, what to do if your symptoms are getting worse and what emergency action to take if you’re having an asthma attack.
GPs in England were permitted to suspend conducting annual reviews for three months between April and June to free up capacity in the first wave of the pandemic, with an estimated 651,000 people missing out on their reviews during this period.5 NHS England is now asking practices to deliver normal care again.
Asthma UK has called for NHS England to support GP practices with addressing the backlog of annual reviews by prioritising those most at risk. People need to be offered video and telephone consultations for their review, as well as face-to-face consultations.
Emma Rubach, Head of Health Advice at Asthma UK, said: “We are deeply concerned that these figures show millions of people could be heading into this winter with poorly controlled asthma.
“If you’re using your reliever inhaler three or more times a week, it is a strong sign that you are at increased risk of an asthma attack and you need to book an urgent appointment with your GP or asthma nurse. All GP surgeries should be able to do this remotely.
“The earlier you get help, the easier it will be to treat you. Ensuring your condition is well-managed could prevent you from ending up in hospital or, in the worst case, save your life.”
Sarah MacFadyen, Head of Policy and Public Affairs at Asthma UK, added: “It’s completely unacceptable that some people with asthma are still unable to access their basic care, putting them at increased risk of potentially fatal attacks.
“GP practices are working in incredibly difficult circumstances and must be better supported to address urgently the backlog of annual asthma reviews, which will avoid an influx of asthma patients needing emergency treatment in hospitals later down the line.
“Acting now will save lives and take pressure off the health service as it faces the most challenging winter in its history.”
Top tips for a remote annual asthma review
- Make a plan: make sure you know how and when your health care professional (HCP) will contact you and find somewhere quiet to take the call
- Check your connection: whether telephone signal (for phone calls) or 3G/4G/Wi-Fi (for video call)
- Be prepared: have a list of things that you want to say and have anything you might need with you eg inhalers, peak flow meter, asthma action plan
- Give it a try. For most people, most of the time, telephone and video calls are a good way of communicating with your HCP. But if it doesn’t work, let your HCP know and ask to revert to a different way of communicating.
Notes to Editor
1. Annual Asthma Survey 2020. Data unpublished, report due in May 2020. Data collected July-September 2020. 58% of respondents (4502 / 7790 respondents in England) told us they used their reliever inhaler more than twice a week. We applied this to the 58% to the 4.5 million people in England with asthma (Health Survey for England data, 2001).
2. Over the past five years of complete data (2014-2018 inclusive), an average of 1319 people have died each year in the UK. This is 3.61 deaths a day. Data via Office for National Statistics (England and Wales); National Records of Scotland; Northern Ireland Statistics and Research Agency (NISRA).
3. Asthma UK and British Lung Foundation survey, 2020. Data collected 10th – 19th October. 25% (911 / 3701) of respondents with asthma in England told us they had delayed or avoided getting regular care since July.
4. Asthma UK and British Lung Foundation survey, 2020. Data collected 10th – 19th October. 22% (811 / 3701) of respondents with asthma in England told us that their regular care for their asthma had been cancelled since July.
5. According to QOF data for GPs in England, 219,000 asthma reviews in England are conducted each month. https://digital.nhs.uk/data-and-information/publications/statistical/quality-and-outcomes-framework-achievement-prevalence-and-exceptions-data/2019-20.
About Asthma UK
Asthma UK’s mission is to stop asthma attacks and, ultimately, cure asthma. We do this by funding world leading research, campaigning for improved care and supporting people to reduce their risk of a potentially life-threatening asthma attack. We are entirely funded by voluntary donations. For further information, please visit: asthma.org.uk.