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Simple measures can save lives – Improving asthma care for children across London

7th September 2017

Vin Diwakar, regional medical director for NHS England (London), writes about the next steps for improving care for children and young people with asthma in London

When taking up the role of regional medical director last year, I was determined to address some of the health challenges that faced the capital and to maximise on the opportunities that present themselves; to improve people’s lives, reduce inequalities and change the way we organise health and social care so the focus is on the patient and not the institution.

In March this year, I received a Section 28 letter from the coroner following the death of a child from asthma in London. The letter described opportunities for health professionals to have improved the management of his condition. Asthma deaths in young people are rare and have reduced substantially over the years. In 2015 there were 16 deaths under the age of 20 years, the lowest recorded in the last decade. Nonetheless, each individual case is a tragic loss and often associated with preventable factors. In this particular case, it appears the child’s condition was not managed in accordance with the stated asthma guidelines, especially in treating asthma not as episodic but rather as a long term condition. Sadly this case has many similarities to other asthma deaths.

Each year over 4,000 children and young people make an emergency hospital admission in London as a result of an asthma attack. Of these, 170 have attacks are so severe that they require intubation and ventilation at one of our paediatric intensive care units. Asthma is a condition which can and should be managed in the community and when managed well sees children with asthma lead normal, healthy lives.

This has re-affirmed my belief, as a practising paediatrician and as the regional medical director, that more needs to be done about asthma care in London.

This is why I am supporting the HLP and NHSE London campaign; AskAboutAsthma, to raise awareness of the simple measures that can be taken to manage asthma in the community. Its aim is to ensure that existing London asthma standards are met across London and that no more children die from preventable asthma attacks. The three simple steps to take to ensure basic consistent care for children and young people are;

These are simple measures that when followed consistently help children and young people better manage their asthma. So why aren’t they always followed? In my role I speak to numerous clinicians across the capital. I was speaking to a group of GPs recently who told me about a teaching session they had on the basics of managing childhood asthma, following the three simple ‘Asks’. They said they thought they knew all there was to know about this common condition but found there was much in the film to be learned. For this reason Healthy London Partnership has produced many helpful films,  one which replicates some of this teaching around the completion of an asthma action plan.

Having an annual asthma review is an example of good practice in asthma management and presents a good opportunity to check the asthma management plan is relevant, dosage is right, there is an effective inhaler technique and flu jabs are up to date. To help GPs, practice and asthma nurses, HLP has produced a guide on undertaking an annual asthma review.

Please support the AskAboutAsthma campaign by pledging your/your organisations support on the My Asthma Pledge page. I will be tweeting #myasthmapledge and my support for #AskAboutAsthma from @Vin_Diwakar. Please do follow suit, but more importantly please ensure you carry out your pledge to improve the lives of children and young people with asthma in London.

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