Exclusive: One in three PCTs 'fail' on asthma care

One in three PCTs in England have no respiratory disease lead and half have not carried out service assessments recommended by the DoH, a GP newspaper investigation has revealed.

Asthma inhaler use (Photograph: GAVIN KINGCOME/SPL)

However, many PCTs are scrutinising the way GPs prescribe respiratory medicines.

Of 99 PCTs that responded to a request for information, 46% are examining individual practices' asthma prescribing. However, even among this group, 29% have not appointed a respiratory lead.

In addition, only 48% of PCTs have used disease information management tools to analyse the number of emergency bed days attributable to asthma attacks. In May, the then health secretary Alan Johnson recommended that all PCTs should carry out such an assessment as part of measures to tackle health inequalities.

In addition, half of the PCTs that have not examined emergency bed days attributable to asthma are examining GP prescribing.

Somerset GP Dr Steve Holmes, a member of the General Practice Airways Group (GPIAG), said it was ‘imperative' that PCTs respond to the needs of respiratory disease patients. ‘A respiratory lead in every PCT is achievable, and should act as a driver for improvements in patient care,' he said.

Leicestershire GP and GPIAG member Dr Dermot Ryan said that the findings showed the need for PCTs to engage with clinicians with designing services to meet patients' needs. ‘It is difficult to know what those needs are unless a baseline assessment is performed,' he commented.

Neil Churchill, chief executive of Asthma UK, said: ‘It is hugely disappointing that such a large percentage of PCTs are still not taking respiratory conditions like asthma more seriously.

‘There are over 200 emergency admissions for asthma every day in the UK, costing the NHS over £61m per year. We believe that up to 75% of these admissions could be avoided but unless PCTs monitor how they are performing, they will waste money and cause thousands of patients the unnecessary distress of an emergency admission. It is vital that all PCTs have an appointed respiratory lead or these figures are unlikely to change.

‘We are working with a number of PCTs across the country to try to improve the standard of care for the 5.4million people suffering with asthma in the UK but it is crucial that health commissioners recognise that far more needs to be done.'

British Lung Foundation chief executive Dame Helena Shovelton said: ‘We are delighted this information has become available.  It is depressing and shocking that only two thirds of PCTs have a respiratory lead.  Respiratory disease is a huge killer in the UK and needs to be put at the heart of care for everyone all over England.

‘It is also concerning that so few PCTs use the management information tools available which could help them analyse and manage asthma better and avoid hospital admissions.  When taken with the information that so few do a proper analysis of asthma control through medication it is a bleak picture for people with asthma and the other lung diseases like COPD.  If they do not get help from their PCT through primary and secondary care who can they turn to for help?

‘We urge every PCT to re-examine their policies and priorities and put in place proper systems to deal with those people affected by lung disease who need their help.'

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