UK Asthma Deaths ‘Preventable’, Study Warns

6 May 2014

UK Asthma Deaths ‘Preventable’, Study Warns

A leading report warns that two thirds of asthma related deaths within the NHS are avoidable.

A national review, led by the Royal College of Physicians, has found that failings by GPs and health services are contributing to deaths amongst asthma sufferers-with two thirds of those deaths found to be avoidable. Shockingly, the numbers of preventable deaths predominately include children, with experts warning that the deaths represented “a tragic waste of life”.

Deaths as a result of the respiratory related condition are currently at their peak in the UK with statistics showing that the total numbers of fatalities are not showing any signs of reduction. The National Review of Asthma Deaths conducted a single study in 2012-the largest of its kind-into the circumstances surrounding asthma related deaths and found that amongst the 195 deaths in the UK, 1,250 people died from asthma. This represented a 10 per cent rise in three years and worryingly the review found that 800 of those deaths could have been preventable had the correct patient care protocols were being followed.

Mistreatment.com has seen how asthma care has been compromised by incidences of potential medical negligence after speaking to members of the public who have called through to us with their own claims. Many of the same indicators of medical negligence we have spoken to our clients above arose in the findings of the national review and mortality reports.

The review concluded that of the numbers of children who died, 90% of the cases that arose could potentially have been avoided, with “major avoidable factors” indicative amongst them contributing towards the medical negligence that occurred. These major factors included:

-Too many GPs prescribing the wrong medication to patients in an attempt to cut costs

-Delegating specialist asthma care to untrained practice nurses, and most worryingly of all

-Giving asthma sufferers blue “reliever” inhalers instead of brown “preventive” inhalers which contain low doses of steroids and are prescribed to stop attacks, and so placing them at significant risk in the process

Asthma affects 5 million people in the UK and the authors of the report opined that there was widespread complacency about the condition and its dangers within the NHS. The report found that large numbers of clinical staff were not aware of the risks of asthma which resulted in the condition not being treated correctly.

Where symptoms of the condition had worsened there were numerous examples of failure by medical professional to act promptly on clear signs where patients were placed in danger due to neglect.

Information within the report further showed that while patients were deteriorating, clear signs of the asthma having worsened were repeatedly missed. 50% of those who died from asthma had previously been admitted to hospital for their condition and 30% of those who died had visited A&E departments the year before due to the severity of their attacks. Yet these warning signs were repeatedly missed, another example of the complacency within the NHS towards how dangerous asthma can be if unchecked.

Children placed in danger due to neglect

Charities said that the blunders had placed patients-most of them children-at significant risk and represented a “frankly horrifying” indictment of current practices in dealing with asthma.

Even those patients who showed elevated symptoms and needed specialist care were not referred to a specialist with GPs failing to review their care in the year before they died. These kinds of errors were found to be “basic” and should have been picked up as a matter of protocol, but largely were missed.

What is worrying is that they seemed to have not been missed out of pure absent mindedness or negligence, but rather through a very coordinated means where adherence to cutting costs came ahead of good patient care.

Kay Boycott, chief executive of Asthma UK, said: “This confidential inquiry has identified prescribing errors of a frankly horrifying scale and is a damning indictment of current routine practice.

A damning indictment of current routine practice

“In many of these cases the warning signs were ignored; past attacks are a clear risk factor for future attacks but more than two thirds of the people admitted to hospital in the month before they died didn’t get properly checked up afterwards.”

The review found that many of the failings in care cropped up in cases where children and young people were concerned.

Ms Boycott said: “Parents of children with asthma will be especially horrified that the confidential inquiry showed that children fared worse than adults in multiple aspects of care, and fell well below expected standards in almost half of child deaths.”

Parents of children with asthma will be especially horrified

With asthma requiring such specialised treatment, the lack of patient care was shocking with basic indicators being completely missed. For example, of the patients who demonstrated high risk indicators and whose asthma had worsened, almost half of them were given high numbers of reliever inhalers, which are only supposed to be used two to three times a week. Other examples of potential medical negligence showed a lack of medication being provided to patients to prevent asthma as well doctors prescribing the cheapest possible medical medication, more worried about cost than patient care.

Dr Mark Levy is the report’s lead author and believes that if GPs had properly monitored patients and not put cost above care, most of the avoidable deaths could have been prevented. He said:

“The main problem is that too many reliever inhalers are being prescribed without the clinicians — doctors and pharmacists — recognising that these people actually have poorly-controlled asthma and need to be prescribed preventive medication. Another issue is that there is a lot of pressure on prescribing costs — so doctors are trying to prescribe economically and not necessarily with clinical efficacy.”

Experts said that, when asthma is properly controlled through preventive medication, patients should not need to use reliever inhalers more than three times a week.

The tragic waste of life outlined in this report is shocking

Dr Levy said: “If people are using it more frequently and they are not getting relief that lasts for four hours they need to phone up their GP and say their asthma is out of control and they need to be seen urgently.”

Dr Peter Carter, general secretary of the Royal College of Nursing, said: “The tragic waste of life outlined in this report is shocking.”

If you or a loved one has asthma and are concerned about the treatment you have been experiencing or have experienced, our specialist asthma and respiratory related condition teams would be pleased to provide advice, guidance and support about your rights under the law and to help you with making a complaint or initiating a medical negligence claim if the circumstances of your case merit this form of investigation into what happened.