Taskforce’s letter marking a decade since the National Review of Asthma Deaths

7 May 2024

Dear Victoria Atkins MP, 

Urgent action needed to address asthma mortality rates in the UK following 10 years of inertia 

In the time it takes for you to read this letter, 21 people will have had a life-threatening asthma attack and this is entirely preventable.  

The Taskforce for Lung Health, representing leading experts, patients and professionals in respiratory care, write to you to urgently address the concerning state of asthma outcomes in the United Kingdom ten years on from the National Review of Asthma Deaths (NRAD). Immediate actions needed to improve safety for people living with asthma includes immediately setting a zero-tolerance target for avoidable asthma deaths and implementing our world-class national asthma guidelines. 

The UK has been at the forefront of developing guidance, with asthma guidelines due later this year, auditing outcomes and cutting-edge research for patients with asthma, but we haven’t implemented an effective nationwide strategy to optimise patient care as the starting point. 

Despite recommendations outlined in the NRAD in 2014, many of which have been repeatedly highlighted in UK research, little progress has been made. The consequences are dire, with over 12,000 people with asthma having lost their lives in the last ten years. We cannot allow this to continue. It is time for bold and decisive action to save lives. 

The statistics paint a grim picture, hospital admissions due to asthma have risen by 46% over the past decade, and the burden of disability-adjusted life years lost to asthma-related disability is the highest in Europe. These figures represent a £13.8bn impact on the English economy from lung conditions. 

The UK has the worst death rate for lung conditions in Europe and the highest for childhood asthma deaths in Europe. In contrast to the stagnation observed in asthma outcomes, other major conditions have seen significant reductions. For instance, the number of UK people dying avoidably from heart disease in the last 20 years fell by 58%, but for lung conditions the death rate has only fallen by 14%. These successes show focused initiatives and proactive measures can reduce preventable deaths. 

The lack of progress in asthma management is particularly concerning given the clear recommendations outlined in the NRAD. Simple interventions, such as appropriate patient and healthcare professional education, the provision of asthma action plans, inhaler technique checks, optimising asthma treatment regimes, and minimising reliance on rescue medications, could prevent many asthma deaths. Despite having access to advanced treatments, including alternative anti-inflammatory relievers and specialist biologic therapies, implementation remains inadequate. 

Therefore, we urge the Department of Health and Social Care to create a national respiratory action plan to shift the UK from laggard to leader in asthma care and treatment by taking the following actions: 

  1. Set a zero-tolerance target for avoidable asthma deaths. 
  1. Support the implementation of the national asthma guidelines (due to be published later this year) by ensuring ICBs prioritise asthma care and treatment for high-risk individuals. 
  1. Introduce incentives to ensure post attack reviews by appropriately trained healthcare professionals, reduce use of SABA and oral steroids, and increase uptake of preventative treatments and also biologics for severe disease. 
  1. Mandate referrals to specialists for anyone who has had two or more hospital admissions in a year for asthma. 
  1. Investment in appropriately trained respiratory workforce across the NHS. 

The current state of asthma treatment and care in the UK is unacceptable. We cannot afford to wait any longer while lives are needlessly lost. We urge swift and decisive action to implement the recommendations outlined above. Government must ensure that every individual living with asthma receives the care and support they need to live a healthy life. 

We stand ready to support and collaborate with the government to improve lung health outcomes across the UK. 

Yours sincerely, 

Henry Gregg – Chair, Taskforce for Lung Health