Delivering good, year-round basic care in the community is vital to keeping patients well and out of hospital, particularly in the winter months. Our supporters have told us that there has been a collapse in care in recent years, with only 32% receiving the basics of asthma care (having an asthma action plan, an annual review and an inhaler technique check) and 10% receiving COPD care (offer of treatment and support to stop smoking, offer of pneumococcal and influenza vaccinations, co-developed personalised self-management plan, offer of pulmonary rehabilitation if eligible, and optimised treatment for comorbidities).
Basic care levels and annual review provision data come from our Life with a Lung Condition survey 2024, a survey of over 12,000 people living with a lung condition in the UK. Results are presented at regional level due to a limited response rate at ICS level.
Basic care is essential for people living with lung conditions. Delivered at scale basic care (including annual reviews, vaccinations, and pulmonary rehabilitation) has the potential to enhance quality of life, reduce hospitalisations, improve healthy life expectancy, and alleviate winter pressures on the NHS.
Providing basic care is also cost effective. Analysis by Asthma + Lung UK and PwC on the cost savings of delivering annual reviews with an inhaler technique check found savings of £7 million a year across England, achieved as a result of patients gaining control over their condition. £244 million savings would be achieved in indirect costs such as improved productivity as this patient group become more economically active as a result of better health.
Self-management apps can reduce the incidence of exacerbations and emergency admissions for people living with lung conditions, but their use can be limited by data poverty, poor connectivity and low digital literacy. This further exacerbates the poor outcomes for those experiencing deprivation. ICSs can also face difficulties in clinical adoption and challenges with procurement. These barriers need to be addressed if the government is to achieve its shift from an analogue to a digital NHS.
What the data shows
Most ICSs that responded to the survey said that they have self-management apps in use for asthma and COPD [25/32].
Despite very low levels of basic care being reported, the majority of our supporters, over 80%, reported receiving an annual review which is encouraging. However, this means that other elements of basic care are lacking – 40% of our asthma supporters reported not having their inhaler technique checked and 51% did not receive a written asthma action plan. Even worse, 66% of our COPD supporters did not receive a personalised self-management plan, 46% didn’t have their treatment optimised for their comorbidities and 44% didn’t receive an offer for smoking cessation support if eligible. This demonstrates that the quality and content of annual reviews is hindering the ability of patients to effectively self-manage their conditions. This needs to be addressed to provide patients with good quality care.
What is Asthma + Lung UK calling for?
- Keep patients well and out of hospital, particularly in the winter months, by delivering good year-round basic care in the community, including annual reviews, vaccinations, and pulmonary rehabilitation, to all those with lung conditions.
- Support ICSs to deliver proactive care facilitated by the roll out of digital tools to keep patients well within the community and out of hospital, especially over winter.
- Implement national minimum standards for ICSs to ensure that all major respiratory conditions are diagnosed and treated effectively, with under-performing ICSs held to account.
Note: review dates refer to the page content rather than the data visualisations