Less than half (48%) of adults admitted to hospital with asthma saw a respiratory specialist within 24 hours of their admission, according to the latest report from the National Respiratory Audit Programme (NRAP).
The NRAP report, Breathing Well, found a similar picture for patients with COPD – 62% had a specialist respiratory review within 24 hours.
Between April 2022 and March 2023, there were 62,907 admissions for COPD exacerbations, and 15,889 admissions for asthma attacks in adults; 4,886 children aged 1–5, and 5,647 children aged 6+ were admitted with asthma.
Only 1 in 5 (21%) adult patients with asthma were given oral corticosteroids within an hour of their arrival in hospital; 65% of children and young people had to wait over an hour before being given OCS.
The report says that all respiratory patients should have a specialist review within 24 hours, and all asthma and COPD patients who smoke should be offered help to stop before they are discharged. Currently, around 60% of patients with COPD, and about 70% of patients with asthma are referred to smoking cessation services. Smokers who are parents of children with asthma should also be referred.
Furthermore, all respiratory patients should be provided with an up-to-date personalised care plan before they leave hospital. At the moment, less than half of children and young people have a current self-management plan on discharge.
The report also calls for improvements in the delivery of pulmonary rehabilitation services: only 12.6% of COPD start PR within 30 days, and 32% start within 90 days.
CVD prevention audit
The National Audit of Cardiovascular Disease Prevention in Primary Care (CVDPrevent) has found that women with CVD were less likely than men to have a recent prescription for a lipid lowering therapy (LLT). They were also more likely than men to have never been prescribed an LLT or to have been prescribed an LLT in the past, but not recently.
Women were also less likely to achieve threshold cholesterol levels compared with men.
Based on data up to December 2023, these inequalities were present in all age groups, in all geographic regions of England, and were consistent over time.