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Learning lessons will improve asthma care

14th September 2017

With 12 children in London dying of asthma each year, paediatrician Ronny Cheung writes about tackling the factors that contribute to these avoidable outcomes

Asthma is the most common long term condition of children and young people in the UK.  Most of us have a relative or friend who has a child with asthma and in every classroom there are approximately 2-3 children who suffer from asthma to varying degrees.

It is sometimes easy to forget therefore that asthma can kill. In 2014, 12 children in London died of asthma. As a paediatrician, I have the tragic job of treating many children in their final battle against asthma. For many of them, they have been failed by professionals in health, education and social care as opportunities to avoid their deaths have been missed.

Since 2008, all unexpected deaths of children have been systematically reviewed by a panel of independent experts from health, social care, policing and other services. This is to ensure that factors which might have contributed to those deaths can be identified and that professionals and services can make changes to prevent these tragic events happening again in the future.

We are one of only a handful of countries that has this spotlight on child deaths.  We are fortunate to have this and should be rightly proud of the remarkable work that these Child Death Overview Panels (CDOPs) have done to change the system for the better; ensuring the learning from these reviews improves the lives of children.

There is however much more that needs to be done. In 2014, a national review of the circumstances surrounding asthma deaths concluded that only 38% of child death reviews were sufficiently thorough, rigorous and expert to fully extract the learning that was available to prevent future deaths.

The Healthy London Partnership (HLP) CDOP programme has been working closely with the HLP asthma programme to tackle this. We have run workshops and provided resources and training in the review of deaths relating to asthma to help CDOPs tackle factors which may contribute to the deaths of children with asthma.

These factors include public health interventions, improving healthcare for children with asthma among GPs and hospital doctors and providing training and support for schools. We have also developed a review checklist to support CDOP colleagues in delivering a thorough and in-depth review following the death of a child to ensure that opportunities for learning from these tragic events are never missed again.

Whatever the circumstances, the death of a child is always heart-breaking. What compounds such a tragedy is if the death could have potentially been avoided.

About the author

Ronny Cheung is a consultant paediatrician at Evelina London Children’s Hospital and clinical advisor on Child Death, Healthy London Partnership @cheungronny

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