Understanding Asthma in the UK: Care, Costs, and Calls for Change

This episode explores a UK parliamentary debate on World Asthma Day, highlighting the significant impact of asthma across the nation. We explore key statistics: 7.2 million people live with asthma, and tragically, four people die from it daily. Many deaths are preventable, linked to unequal access to care and socioeconomic factors. The debate covered the theme of "Make inhaled treatments accessible for all", discussed the substantial economic cost of asthma, and called for better prevention, improved diagnostics like spirometry and FeNO, increased uptake of treatments like biologics, and prioritizing respiratory health in national plans.

Key Takeaways:

• Asthma is a common but serious condition, affecting 1 in 9 adults and 1 in 8 children in the UK.
• The UK has the highest asthma death rate in Europe, with most deaths considered preventable.
• There is a strong link between asthma severity and deprivation, with those in the poorest communities facing significantly worse outcomes.
• Improving access to inhaled medications and newer treatments like biologics is crucial but faces challenges with uptake and availability.
• Addressing root causes like poor air quality and substandard housing is vital for prevention.
• There are calls for asthma care to be a key priority in the upcoming NHS 10-year plan.

Important Definitions and Concepts:

• World Asthma Day Theme: "Make inhaled treatments accessible for all," highlighting the need for equitable access globally.
• Biologics: Lifesaving treatments for severe asthma, but with currently low and variable uptake in the UK.
• Spirometry / FeNO: Key diagnostic tests for respiratory conditions, efforts are underway to improve community access.

Discussion: Given that asthma disproportionately affects those in deprived areas, what comprehensive strategies, involving different government departments and communities, could effectively address these health inequalities?

Source: World Asthma Day
Volume 767: debated on Thursday 15 May 2025

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No outside chatter: source material only taken from Hansard and the Parliament UK website.  

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Transcript

Amy 0:00

Hello and welcome to The Bench Report. You're listening to Amy and Ivan.

Ivan 0:07

Today we're looking at a recent parliamentary discussion about asthma. It happened around World Asthma Day.

Amy 0:13

And it really focused on the challenges people face with asthma right here in the UK.

Ivan 0:17

It did. And although asthma is very common, I mean, we're talking over 7 million adults, maybe 2 million kids.

Amy 0:23

It's definitely not a minor thing.

Ivan 0:25

No, far from it. Actually, lung conditions are a major cause of death here. Our death rate from respiratory illness is, well, worse than many comparable European countries.

Amy 0:35

The statistics themselves are pretty sobering. Four people dying every day from asthma.

Ivan 0:41

Every day. Every single day. And an asthma attack, a potentially serious one, happens roughly every 10 seconds.

Amy 0:46

And the really concerning part, I thought, was about preventable deaths. Over 12,000 in the last decade.

Ivan 0:53

And that 2014 review finding that two-thirds of those, two-thirds, could likely have been prevented.

Amy 0:59

That preventable word just hangs there, doesn't it?

Financial costs / productivity

Ivan 1:02

It really does. And beyond the human cost, there's the financial side. Asthma and COPD, together... costs the NHS something like $9.6 billion a year.

Amy 1:11

That's huge. Over 3% of the whole NHS budget.

Ivan 1:14

Exactly. And then add lost productivity, people off work. The wider economic hit is maybe closer to $13.8 billion.

Amy 1:22

Wow. And we saw hospital admissions were high too, nearly 57,000 in 2022-23.

Inequality

Ivan 1:29

Waiting lists for respiratory care have just ballooned over the last 10 years, a really significant rise.

Amy 1:34

The discussion also brought up inequality, which seems critical.

Ivan 1:37

Very much so. People in the most deprived communities are, I think the figure was, three times more likely to die from asthma.

Amy 1:43

And children in those areas, four times more likely to end up in hospital as an emergency.

Treatments

Ivan 1:47

It points to much bigger factors than just, you know, medication, housing. On

Amy 1:52

the treatment side, though, there was some positive news mentioned.

Ivan 1:55

Yes, the move towards using combination inhalers more.

Amy 1:58

Instead of relying only on the short-acting blue ones, the SABAs.

Ivan 2:02

Precisely. Because of safety concerns with over-reliance on those. And also development of new lower-carbon propellant inhalers.

Amy 2:12

Which is good for the environment, obviously. And ties into the World Asthma Day theme for 2025.

Ivan 2:16

Make inhaled treatments accessible for all. It really captures the core issue.

Amy 2:23

There were calls in parliament for free inhalers for everyone with asthma.

Ivan 2:27

Because the alternative is quite alarming. A study found 57% of emergency admissions involve people skipping doses because of cost.

Amy 2:34

Which is just terrible. And the idea about dose counters on emergency inhalers.

Ivan 2:39

Seems essential. So many people apparently don't realize their emergency inhaler is empty until they really need it.

Amy 2:44

Which could be disastrous.

Poor air quality

Ivan 2:45

Absolutely. Then there's the air quality link. That came up strongly.

Amy 2:49

Examples from specific areas where poor air quality is clearly driving up respiratory problems.

Ivan 2:54

Yeah. And it connects back to that inequality point. Higher asthma rates often found in more deprived parts of constituencies.

Amy 3:01

Linked to pollution, but also housing conditions like damp and mold.

Ivan 3:05

So it needs a joined up approach, doesn't it? Looking at pollution, housing, transport, lifestyle, not just the Department of Health.

Amy 3:14

Though some government efforts were acknowledged, like trying to improve air quality, the tobacco and vape spill.

Issues with healthcare systems

Ivan 3:19

And the renter's rights bill. With Awab's law tackling damp and mold specifically.

Amy 3:25

But the health care system itself isn't without problems here.

Ivan 3:28

No, definitely not. A big one is that follow-up appointment you're supposed to get within 48 hours of an emergency admission.

Amy 3:35

Most people don't get it right. About two-thirds miss out.

Ivan 3:38

Which is a real gap in care. And asthma deaths actually increased between 2012 and 2020.

'Postcode Lottery'

Amy 3:43

Suggesting things aren't consistently improving. And this idea of a postcode lottery.

Ivan 3:48

Where the care you get really depends on where you happen to live. We heard examples like in Bournemouth West, where maybe 60% of people diagnosed weren't getting basic care checks.

Amy 3:58

And long waiting times to see specialists in some places. Patients not being seen within the NHS target times.

Ivan 4:04

Even concerns about COPD care standards in certain regions being quite poor. M

Amy 4:12

So looking ahead, what were the main recommendations coming out of this?

Ivan 4:15

Well, setting actual national targets to cut preventable asthma deaths was a big one.

Amy 4:20

Makes sense. If they're preventable, let's prevent them.

Ivan 4:22

And improving access to the newer biologic medicines for those with severe asthma. Yeah. Uptake is apparently quite low and patchy across the country.

Amy 4:30

And long waits to get them, too.

Ivan 4:31

Right. Plus, support for digital tools, like apps or monitors, to help people manage their asthma day to day. What about research? A call to review funding for ASA research, definitely. And a continued focus on prevention. Things like vaccinations for flu, RSV, pneumonia, and obviously smoking cessation support.

Amy 4:51

The role of community diagnostic centers, the CDCs, also came up.

Ivan 4:56

Yes, making tests like spirometry, which measures lung function, and phenotesting more accessible.

Amy 5:02

Pheno measures airway inflammation, doesn't it?

Ivan 5:04

It does. And there was an example from Northern Ireland suggesting wider GP access to phenotesting could actually save money and improve treatment targeting.

Amy 5:12

Interesting. Integrating respiratory health properly into the next big NHS plan seems vital, too.

Ivan 5:18

And addressing winter pressures, partly through better year-round respiratory care. Also, things like the core 20PLUS5 initiative trying to tackle those health inequalities we mentioned.

Amy 5:28

And standardizing guidelines, piloting digital annual checks, lots of potential actions.

Conclusions

Ivan 5:34

It seems the core message is progress has been made, yes. But there's still major hurdles.

Amy 5:39

Especially around access, inequality, and joining up different aspects of care and prevention.

Ivan 5:45

The fact that so many deaths are still preventable really underlines the need for change, not just in health care, but looking at air quality, housing, the bigger picture.

Amy 5:55

It all comes back to something as fundamental as breathing. We need to keep the focus on respiratory health for everyone.

Ivan 6:01

As always, find us on social media at Bench Report UK. Get in touch with any topic important to you. Remember, politics is everyone's business. Take care.