National Review of Asthma Deaths

The National Review of Asthma Deaths (NRAD) is the first UK wide investigation into asthma deaths, published on 6 May 2014.

The report, published by the Royal College of Physicians, looked at deaths from asthma between 1 February 2012 and 31 January 2013 in the UK. Asthma + Lung UK contributed to this significant report.

Key findings

NRAD found widespread issues with the quality of asthma care amongst those who died, with several areas of key findings:

  • 46% of asthma deaths were identified as being avoidable, if the appropriate guidelines were followed
  • key elements of routine care were not received, with the majority of people who died from asthma (57%) not recorded as being under specialist supervision during the 12 months prior to death. Personal asthma action plans (PAAPs), acknowledged to improve asthma care, were known to be provided to only 23% of people who died from asthma.
  • prescribing errors were widespread, with evidence of excessive prescribing of reliever medication, underprescribing of preventer medication and inappropriate prescribing of long-acting beta agonist (LABA) bronchodilator inhalers. Help us to stop poor prescribing practice.
  • children fared worse than adults in several respects, and care fell well below expected standards in almost half of child deaths.


NRAD identified a number of avoidable factors in relation to both the care people received, the recognition of risk and avoidable factors relating to patients and their families and environments. The 19 recommendations put forward include:

  • hospitals and general practices having a named clinical asthma lead, and patients attending follow-up appointments after emergency admissions of using the out-of-hours service
  • annual structured asthma reviews, which record known triggers and current treatment
  • appropriate prescribing, and monitoring of inhaler technique. Find out more about inhalers, treatments and medicines.
  • encouraging patient self-management, and education about the exposure to allergens, when and how to use their asthma medication and referring smokers with asthma to smoking cessation clinics

Find out more

Find out about Asthma + Lung UK’s analysis of the National Review of Asthma Deaths, what we believe are the critical findings, and what we think needs to be done.

Alternatively, read the full National Review of Asthma Deaths report. A summary is also available.

Find out about our one year follow-up to NRAD.