Breathing issues are the leading cause of all emergency admissions

Asthma + Lung UK launches its report, ‘A Mission for Lung Health’ tomorrow, warning how years of lung health neglect has pushed the NHS to breaking point, with a staggering 1.7 million admissions to hospitals in England last year for respiratory issues.¹

Asthma + Lung UK is sounding the alarm after new analysis reveals breathing issues are the leading cause of all emergency admissions in England.² With the Government’s new NHS 10-year plan on the horizon, the charity is now calling for lung conditions, the third biggest killer in the UK, to be treated with the same urgency and focus as cancer and heart disease.³

The leading lung health charity says the government cannot give the NHS the breathing space it needs without an urgent and radical overhaul of how lung conditions are prevented, diagnosed and treated. Without this, the recurrent winter crisis and pressure on frontline services will only deepen, with the most vulnerable worst affected. Lung conditions are the most closely linked conditions to deprivation, with those from the poorest communities five times more likely to die from chronic obstructive pulmonary disease (COPD) and three times more likely to die from asthma compared to those in the richest, and twice as likely to experience an emergency respiratory admission in winter.^4,5

Lung health has been long neglected, evident from figures that show breathing issues are the leading cause of all emergency admissions and the main driver of winter pressures.² Last winter saw over 300,000 people admitted with breathing issues including almost 90,000 children.⁶

Breathing issues are responsible for 1 in 8 (13%) emergency admissions in England higher than heart disease, musculoskeletal conditions and cancer.² To tackle the burden breathing issues heap on the NHS during winter, a more proactive, year-round approach needs to be taken to care rather than firefighting each winter.

The charity is highlighting a collapse in care for people with lung conditions, with levels of basic care for COPD at their lowest recorded.⁷ By prioritising prevention and early intervention, the government can dramatically reduce emergency admissions, save thousands of lives, and ease the strain on the NHS for good. They say that improving basic care for asthma and chronic obstructive pulmonary disease (COPD) could save the NHS £729 million annually and reduce hospital stays by over 272,000 bed days, with nearly 100,000 of these during the winter months.⁸

The charity says that if the government is serious about changing the focus from sickness to prevention a complete overhaul in how we treat lung health is crucial. They are calling for a commitment to provide funding to make diagnostic tests available in community settings across the country so that people get on the right treatment earlier, alongside access to vital treatment and basic care that people with lung conditions need to stay well and out of hospital.

While there has been significant progress in reducing mortality rates from heart diseases—down 58% over the past 20 years—lung health has only seen a 14% improvement.⁸ Had it kept pace with heart disease, thousands of lives and millions of pounds could have been saved.

Gemma Fitzsimons’ brother Grant died three years ago following an asthma attack when he was just 36 years old, leaving behind a son, and his fiancé, who was pregnant with their second child.

Gemma said: “After a day out in Blackpool with his son and pregnant fiancé, Grant got increasingly wheezy as the day went on. He thought when he got home that he’d be fine, but that didn’t happen that day.  

“Grant was diagnosed with asthma as a young child and was hospitalised twice. He ended in accident and emergency numerous times, using a nebuliser to help stabilise his breathing. As an adult, he just got on with it, but he was too dependent on his blue (reliever) inhaler really. He used it almost every day, he’d just keep getting his repeat prescription. He didn’t have an annual review or an asthma action plan.

“The most difficult thing now is seeing his family without him. Grant and his partner were busy planning their future, excited about their second child – but he never got to meet his daughter, who is now three year’s old. And he and his son Lucas were very close. He has had to go through big milestones, like going to secondary school, without his dad. Grant took him to all his football matches and they used to watch Bolton Wanderers together. Grant’s best friend takes him now. 

“I think we really need to get the basics right with asthma. It doesn’t need to get to the point of people ending in A&E, there’s so much that can be done before then. It’s so important that people can get the care they need in their community, that they can get to see their GP if they are having problems, so that are not ending up in hospital and more families aren’t being devastated by deaths that could be avoided.”

Sarah Sleet, chief executive at Asthma + Lung UK said: “Lung conditions are silently suffocating the NHS, pushing it to breaking point and causing 66,524 deaths last year. Every day, people with respiratory conditions are needlessly suffering, hospitals are overwhelmed by emergency admissions for breathing issues, particularly during the winter. Without urgent action, more lives will be put at risk. The government’s 10-year plan is a once-in-a-decade opportunity to radically rethink how we improve the lives of people with lung conditions. Without a bold overhaul of how we prevent, diagnose, and treat lung disease, the NHS will continue to struggle, and the cost will be counted in lives lost.

“The NHS is crying out for an all-year approach that focuses on prevention including vaccinations, as well as timely diagnosis, annual reviews and access to treatment, alongside key measures such as smoking cessation, improved housing and better air quality. These efforts could dramatically reduce hospital admissions, relieve pressure on NHS services, reducing health inequalities.”

Dr Ian Higginson, Vice President of the Royal College of Emergency Medicine, said: “Respiratory issues are one of the most common reasons people attend Emergency Departments.

“As we see from these numbers, for hundreds of thousands of people, that trip to A&E leads to admission, and we know that once that decision is made, it is very likely that many of these patients will end up stranded for hours – often on trolleys in corridors – waiting for a hospital bed to become available. 

“It is dehumanising and dangerous and for someone in respiratory distress - where every breath can be a struggle – I imagine it can be terrifying.  Once admitted, it is often to a bed that is not on a specialist respiratory ward.

“The government has put much focus on planned care and tackling waiting lists, and this will help some patients with respiratory disease. However, it must not neglect those living with chronic health conditions who become more unwell.

“Community interventions for these patients, like access to vaccination, specialist nurses and their GP, can reduce the need for hospital admission and when hospitalisation is needed, access to specialist teams and specialist wards can shorten stays and improve outcomes. All this requires evidence-based interventions around emergency care, including improving inpatient capacity for patients with these conditions.”

Asthma + Lung UK wants to reassure the millions of people in the UK living with lung conditions that it can provide help and support wherever you live. If you need advice or support about any breathing symptoms or your lung condition you can give our Helpline team a call on 0300 222 5800 (Monday-Friday, 9am-5pm) and visit our website, which has vital health information. The charity also has more than 150 support groups up and down the country offering support and advice. 

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References

1. NHS England Hospital Episode Statistics 2023/24 show that there were 1,743,429 finished consultant episodes (FCEs) for diseases of the respiratory system (ICD10 code J00-J99). Accessed here.
2. NHS England Hospital Episode Statistics 2023/24. Accessed here.

3. Office for National Statistics Mortality Statistics 2023. Accessed here.

4. Office for National Statistics. Inequalities in mortality involving common physical health conditions – England, 21 March 2021 to 31 January 2023. 2023. Accessed here.

5. NHS England monthly respiratory hospital admissions 2022/23 requested by A+LUK.

*The NHS defines winter as December to March.

6. NHS England monthly respiratory hospital admissions 2022/23 requested by A+LUK.

7. Asthma + Lung UK’s annual Life with a Lung Condition survey results. Basic care for COPD is defined as the 5 fundamentals – pulmonary rehab offer if eligible, smoking cessation treatment and support if eligible, pneumococcal and influenza vaccines offered, co-development of a personalised self-management plan and treatment optimised for comorbidities.

8. Asthma + Lung UK. Saving Your Breath: how better lung health benefits us all. 2023. Accessed here.