Surge in repeat hospital visits for lung conditions

New analysis shows the number of people making five or more emergency visits to hospital a year with breathing difficulties has almost tripled in some parts of the country exposing huge gaps in the treatment of life-threatening lung conditions

Asthma + Lung UK is blowing the whistle on the country’s diabolical record on lung health as data reveals the number of people needing emergency hospital care for breathing issues at least five times a year has risen by almost a quarter nationwide (22.9%)¹ over the last 12 months with shockingly huge increases in parts of the country. 

The charity says the government needs to turn back the clock on years of lung health neglect by prioritising respiratory health in its 10 Year Health Plan, which is due to be published in the next few months. Bold action on lung health is long overdue as the UK has the highest death rate in Europe for lung disease², and breathing issues are the leading cause of all emergency admissions and a driver of winter pressures.³ Limited care and paltry follow-up mean people are being ping ponged in and out of hospital where the focus is on a short-term fix rather than preventative care.

According to the data, 45% of people needing emergency treatment for asthma and 58% for chronic obstructive pulmonary disease (COPD) are repeat attenders⁴ yet only a half of people surveyed with lung conditions are getting appropriate follow-up care⁵. In the same survey, 55% of respondents claimed they would not have ended up in hospital if they had been able to get a GP appointment⁶. Separate data shows a third of people with asthma and less than a tenth with COPD are receiving recommended levels of care^7.

New asthma guidelines⁸ state that if someone has received emergency care, they need to be seen by an asthma expert afterwards, and that everyone with asthma should be reviewed once a year and have an inhaler check. If these guidelines were followed, there would be a drop in repeated emergencies and asthma deaths which have increased by 25% in the last 10 years⁹.Likewise, better COPD monitoring would reduce repeated hospital visits as the risk of someone having a life-threatening COPD flare-up is more likely after a subsequent exacerbation¹⁰.

Although the picture is bleak across the country, the data in five-plus emergency hospital visits exposes huge regional variations, with numbers almost tripling in some areas. But the highest bounce-back level is in the North-East & North Cumbria. Other blackspots include West Yorkshire, Cheshire & Merseyside, Greater Manchester, and Birmingham & Solihull¹¹.

Emma Thompson, 47, from Wiltshire, has ended up in hospital with asthma complications 48 times in the last five years. She says urgent action is needed to improve lung health

“My asthma dramatically deteriorated in 2019 after a horrendous bout of flu which left me fighting for my life. Ever since, I have been living on a knife edge – I can no longer work, and I’m too scared to go out for a walk on my own in case I have an asthma attack.

“On a couple of occasions, I’ve been rushed straight to intensive care, and I have lost count of the number of times that I thought I was going to die. I am lucky that I have a good GP, but my experience in hospital has never been good, and my asthma has repeatedly been dismissed as anxiety.

“The worst experience was in 2021 when the medical team at hospital decided I was fabricating my symptoms. They left me for 45 minutes rasping for every breath, and the experience resulted in me developing medically induced PTSD. Can you imagine a doctor ignoring a patient arriving in hospital with a suspected heart attack or a seizure? It would never happen, but the fact I was having an asthma attack was not seen as serious.

“Asthma and other lung conditions kill people every day and many of these deaths are preventable, but they aren’t taken seriously. I have been told before that I’m not sick enough for emergency care simply because I don’t always have a typical wheeze when my asthma flares up. Surely not being able to breathe is a medical emergency?

“Now, I try to do everything I can to keep myself well. After years of battling for better treatment, I have an asthma action plan, I am taking biologics [targeted therapy to stop lung inflammation] which has made some difference. But my life would be easier if people really understood the dramatic impact lung conditions can have on people’s lives.”

Asthma + Lung UK respiratory champion, Dr Sharada Gudur, who works as consultant respiratory physician in Lancashire, says:

“Lung health in this country is in a critical state, and if urgent action isn’t taken, it will need resuscitation. The challenges are deep-rooted, but they simply cannot be ignored. The irony is that in medical school, respiratory care is the priority as the first thing you are taught to do is to check a patient’s breathing. But in practice, the reverse is true as lung health is rooted in much bigger problems like deprivation, poor housing, and smoking.

“We need real commitment to tackle the roots causes of lung disease, but that’s only part of the problem. People are having repeat exacerbations, especially in densely populated parts of the country like the North-West, where I work, because services simply cannot meet need. The impact of repeat admissions on patients’ mental and physical health is immense. All too often, they don’t receive the respect of dignity they deserve, and the toll on their lungs and other organs really can reduce their lifespan and cause depression.”

Sarah Sleet, CEO at Asthma + Lung UK says:

“It is unacceptable that people with lung conditions are being shunted between primary care and hospitals like this. We are living in the twenty-first century, and nobody should be stuck in A&E, fighting for breath, simply because their basic care has been neglected.

“We know the NHS can’t fix everything at once, but lung health cannot keep falling to the bottom of the pile, nor can we allow people’s postcodes or deprivation to determine their lung health outcomes. We need to see breathing issues taken seriously, and although we welcome government plans to create better neighbourhood health provision this must include a stronger focus on improving respiratory care otherwise these dehumanising and avoidable rebound hospital visits will continue to rise.

“People with lung conditions should not have to battle just to get a diagnosis and effective treatment. We need to turn the dial on sickness by taking a long-term, cohesive approach to prevention, which is why we are calling for the government to ringfence a £40 million fund¹² for vital lung tests; we also want action to tackle mouldy damp housing and air pollution, which both have a huge impact on the nation’s lungs, as well as properly funded services to help people stop smoking.”

Asthma + Lung UK is inviting people to ask their MP to stand up for lung health by following the link here.

-Ends- 

1.In 2023/24, there were 42,050 A&E attendances in which the patient had attended A&E 5 times or more within the year. This is a 22.8% increase on the 2022/23 figure of 34,245 5+ A&E attendances. NHS England Hospital Episode Statistics database 2024.

2. Eurostat. Causes of death – standardised death rate by region of residence 2011-2018. 2023. Accessed here.

3. NHS England Hospital Episode Statistics 2023/24. Accessed here. 

4. NHS England Hospital Episode Statistics database 2024.

5. Asthma + Lung UK’s annual Life with a Lung Condition Survey 2024.

The last time you received emergency/unplanned care at a hospital or out-of-hours centre, did you have a follow up appointment for your lung condition?

6. 55% (2015 out of 3652) of respondents who had received emergency/unplanned care within the last year think that better access to appointments at their GP practice would have helped to avoid the use of emergency care. Asthma + Lung UK’s annual Life with a Lung Condition Survey 2024.

7. Asthma + Lung UK’s annual Life with a Lung Condition Survey 2024. Basic care for asthma entails having a written personalised asthma action plan, an annual review, and an inhaler technique check. Basic COPD care, known as the five fundamentals of care, comprise a co-developed personalised self-management plan, pulmonary rehab offer, if eligible, stop smoking treatment offer if eligible, offer of pneumococcal and influenza vaccinations and optimised treatment for comorbidities. 

8. Asthma guidelines 2024. Accessed here

9. ‘Asthma care is in crisis’ – charity sounds the siren as death toll rises. Asthma + Lung UK; April 2024. Accessed here.

10. Prognostic risk factors for moderate to severe exacerbations in patients with chronic obstructive pulmonary disease. Accessed here.

11. NHS England Hospital Episode Statistics database 2024. 5+ A&E attendances in 2023/24 compared with those in 2022/23. 

Only 5 ICSs with the most 5+ A&E attendances and 5 ICSs with the least 5+ A&E attendances compared to previous year as shown. 

Only 5 ICSs with the biggest increase and 5 ICSs with the smallest increase in 5+ A&E attendances compared to previous year shown. 

12. A Mission for Lung Health, p6. Asthma + Lung UK; November 2024. Accessed here.