Health services need to improve the management children with asthma, according to official investigators.
The report was released for World Asthma Day today and written for the Healthcare Safety Investigation Branch, part of NHS England which investigates the safety of NHS-funded care.
It outlines the challenges of diagnosing and managing chronic childhood asthma, giving the example of a five-year-old who had a near fatal asthma attack and who had never been formally diagnosed with asthma despite being treated for respiratory symptoms.
This case "illustrates potentially life-threatening consequences if the condition is not recognised", the authors state.
The report highlights challenges with adherence to treatment, and with the understanding of chronic asthma among health care professionals, parents, families, carers, schools, and pharmacies.
Gaps can occur in the clinical oversight of a child’s care, particularly during changes to accommodation and schools, resulting in poor communication and record keeping.
The report recommends new system-level solutions such as novel resources to encourage behaviour change, and better digital integration and information sharing.
“Our investigation offers an independent view on why there continues to be serious safety risks associated with the diagnosis and management of chronic asthma in children," said author Keith Conradi.
"It identified learning that can positively influence changes in practice across the NHS and help empower health care staff, parents, carers and patients in managing the condition effectively. The aim with our safety recommendations is to improve outcomes for children and young people with asthma and prevent families from experiencing devastating loss.”
Paediatrician Dr Jen Townshend, who assisted the investigation, said: “Outcomes for children and young people with asthma in the UK continues to be amongst the worst in the developed world and twice as bad as the next worst country in Europe. As a result, many children are living with intrusive and unnecessary asthma symptoms and sadly every year children and young people continue to die from asthma. In many cases these deaths are preventable.
“The HSIB report reinforces the findings from the 2014 National Review of Asthma Deaths and highlights specific areas for improvement with clear lines for accountability to ensure these recommendations are addressed.”
Asthma UK today released its own report for World Asthma Day, warning of the impact of the pandemic on patient care.
It found that 28% of patients have not had an annual asthma review and 21% have not had their inhaler technique checked.
It said care levels are “stagnating” with 3.5 million people not getting basic care.
Clinical leader Dr Andy Whittamore said: “It is deeply concerning that so many people including some of the most at risk of an asthma attack are not receiving any basic care which could keep them well and out of hospital. Everyone working in the NHS is trying their hardest in these unprecedented circumstances but it is still vital that everyone with asthma gets the care and support they need to avoid a potentially life-threatening asthma attack.
“GPs need to balance clinical need and what patients want. People experiencing uncontrolled symptoms must be prioritised for an assessment with their GP surgery as they might benefit from a more thorough assessment which may require a face-to-face appointment. “
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