MORE than one million people with severe asthma are at an even greater risk of an attack after not seeing a doctor for a year.
Asthma UK has said it is “deeply concerned” about the lack of care that asthmatics have received during Covid.
The leading charity’s research estimates that almost a quarter (24 per cent) of people with “uncontrolled symptoms” of asthma have not had a face-to-face asthma review in the last year.
This equates to around 1.28 million people, the charity said.
While some of these people received remote consultations, it is predicted 623,000 people across the UK had no annual asthma review at all.
It is easier for GPs to spot if someone with asthma is struggling with their condition face to face.
They can check their lung function with tests and ensure they are using their inhaler correctly.
This is vital as previous research has shown nearly half of people with asthma do not using their inhaler properly, which means that the full dose of the medicine can’t get into their lungs.
Dr Andy Whittamore, Clinical Lead at Asthma UK and the British Lung Foundation and a practising GP 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."
Asthma attacks killed 1,420 people in 2019 – nearly four people each day.
The chances of an attack are significantly reduced if patients are on the right medication, and taking it correctly.
On World Asthma day, Dr Whittamore urged people who have severe asthma – such as if they are using an inhaler three times a week or more – to urgently see their GP for a check-up.
Other symptoms of uncontrolled asthma include waking in the night feeling breathless, with a cough, tight chest or wheezing.
‘Seeing a doctor after my asthma attack would have given me reassurance’
Daniel Taylor, 27, was only able to get a GP appointment over the phone after having a major asthma attack in October 2020.
The gardener from Manchester said: “My asthma took a turn for the worst when I started waking up at night with a tight chest, feeling wheezy and breathless.
“I managed symptoms at home with my reliever inhaler, but two days later I had an asthma attack. I was coughing uncontrollably and could barely talk. It was terrifying.”
Daniel’s wife took him to A&E where he was treated before having a consultation on the phone with a nurse two days later.
My wife drove me to A&E where I was put on equipment to help me breathe and given steroid tablets to help calm down the inflammation in my airways.
The NHS website says after an asthma attack, a patient should see a GP or nurse within 48 hours of their hospital stay, or ideally on the same day.
Daniel said: “I was hoping to be offered the option of a face-to-face appointment especially because I had just received emergency treatment in hospital, but I wasn’t given the choice.
“Being seen face-to-face would have given me the reassurance that I am OK and that I am using my new inhaler correctly, something which I’m not confident in, especially because it’s been over a year since I’ve had this checked.
“I think it’s so important that people with asthma are made to feel like they have a choice in how they receive care because phone and video appointments don’t work always work for everyone.”
“The fact that so many people living with asthma are still not receiving the support and care they need is unacceptable,” said Alison Cook, Director of External Affairs at Asthma UK.
Ms Cook, Chair of the Taskforce for Lung Health, said: “At a time when we are more conscious of our lungs than ever before, it is particularly troubling to see that in the past year, as many as 450,000 people living with uncontrolled asthma have not been informed about how to use their new inhalers properly.”
Asthma UK’s research, which involved 12,000 survey respondents, also suggested that 3.5 million people with asthma have not received all elements of basic asthma care.
This includes a yearly review, an inhaler technique check and having a written asthma action plan.
People aged 18-29 (29 per cent) and those living in the North West of England (32 per cent) and Wales (28 per cent) had the lowest rates.
Experts said that overall, asthma care levels are stagnating due to the backlog of care created by the pandemic.
What to do if you have an asthma attack
If you think you're having an asthma attack, you should:
- Sit upright (do not lie down) and try to take slow, steady breaths. Try to remain calm, as panicking will make things worse.
- Take 1 puff of your reliever inhaler (usually blue) every 30 to 60 seconds, up to a maximum of 10 puffs.
- Call 999 for an ambulance if you do not have your inhaler with you, you feel worse despite using your inhaler, you do not feel better after taking 10 puffs or you're worried at any point.
- If the ambulance has not arrived within 15 minutes, repeat step 2.
Never be frightened of calling for help in an emergency.
Try to take the details of your medicines (or your personal asthma action plan) with you to hospital if possible.
If your symptoms improve and you do not need to call 999, get an urgent same-day appointment to see a GP or asthma nurse.
This advice is not for people on SMART or MART treatment. If this applies to you, ask a GP or asthma nurse what to do if you have an asthma attack.
It comes as a safety watchdog has called for more action to prevent potentially fatal asthma attacks in children.
The Healthcare Safety Investigation Branch (HSIB) said there was a “general lack of understanding about the potential seriousness of asthma”.
It reviewed the case of an asthma attack in a five-year-old boy who nearly died in July 2019.
The unnamed boy needed seven weeks of hospital care, including 13 days in intensive care.
The HSIB pointed to a “lack of capacity” at the child’s hospital which meant he waited “much longer” than he should have done between appointments.
After reviewing the case, investigators looked at wider issues surrounding asthma care.
It said there was a lack of communication between health officials and schools and inconsistency using both paper and electronic records, for example.
Dr Jen Townshend, a consultant paediatrician who advised on the HSIB 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.”
An NHS spokesperson said: “The NHS is already implementing the recommendations of the report with improved asthma care at the heart of the NHS Long Term Plan, which committed to improving asthma outcomes for children and young people.
“The NHS spends around £1 billion a year treating and caring for people with asthma and helping them get back to good health, while national experts are working on developing a new national framework to be implemented across the country to further improve care for children and young people suffering from asthma.”
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