Gaps in asthma care in Wales putting children at risk, leading lung charity warns

Ethan is only six years old but has been into hospital because of asthma attacks more than 15 times in the past four years. Credit: Family photo

Asthma is common, in fact 59,000 children in Wales live with it. But if it's not managed properly, it can be life-threatening.

One mother who knows this all too well is Gemma Perkins, 36, from Bridgend. Her six-year-old son, Ethan, has been hospitalised more than 15 times in the past few years because of his asthma.

She wants to see more support and education around managing the condition, to help prevent her son and others like him from returning to hospital and "fighting for breath again".

It comes as a major audit of most GP practices in Wales has highlighted "worrying gaps" in children's asthma care, according to Asthma + Lung UK Cymru.

The charity's analysis of the data shows that children could be at risk of avoidable asthma attacks and hospitalisations because they haven't had access to lifesaving basic care.

59,000 children in Wales have asthma. Credit: PA Images

Gemma Perkins' son Ethan has asthma and he has been hospitalised more than 15 times since 2018 because of the condition.

Gemma recalled that at one point the severe attacks were happening so often, Ethan was being taken into hospital every month.

She said: "Ethan started having asthma symptoms, such as wheezing and breathlessness from the age of two.

"At one stage, his asthma attacks were so bad that he was being hospitalised every month for two days at a time. Changes in weather and hay fever play are major triggers for him, so regular appointments and check-ups are really important to keep him safe and well.

What is asthma?

59,000 children in Wales have asthma, a serious lung condition that can cause symptoms such as coughing, wheezing, feeling breathless or a tight chest.

"November 2021 he was admitted to hospital, but he didn't respond to treatment. It was the scariest thing we have been through as a family. I never want to see Ethan fighting for breath again.

Gemma recognised that NHS services are under a great deal of strain but said more education on the topic will make sure children like Ethan can stay out of hospital.

She said: "I understand that GPs are under a huge amount of pressure at the moment, but more needs to be done to ensure everyone with asthma gets the help they need, so people feel supported in managing their condition.  

"We need to be more informed and supported to ensure our child's asthma is well managed, so in future Ethan avoids hospital."

Ethan starting suffering with asthma symptoms when he was two years old. Credit: Family photo

Asthma + Lung UK Cymru analysed data from 314 (80.7%) practices in Wales between April 2020 to 31 July 2021, and found that:

  • Only 22% of children received a personalised asthma action plan in the past year. 

  • Only a quarter (24.9%) of children with asthma in Wales had their inhaler technique checked - a key part of self-managing the condition.

  • Only a third of children recently diagnosed with asthma have a record of having tests done to confirm this - half the level in 2020.

Charity experts warn poor basic care can contribute to asthma attacks and unnecessary hospitalisations. 

Joseph Carter, Head of Asthma + Lung UK Cymru said: "These findings highlight worrying gaps in children's asthma care.

"Covid-19 has presented huge challenges for the NHS and for children with asthma, with disruption to their routine asthma care being one key consequence. Children have been set to the side-lines and parents have been left to self-manage without a proper care plan in place.

"Big changes are needed to protect little lungs.

"We must raise the expectations of parents, so they get the right support, information and receive this at the right time.

"GPs and practice nurses play a huge role in ensuring children with asthma receive the basic care to ensure they can live well and manage their condition.

"We are calling on the Welsh Government to respond to the NACAP audit by ensuring that everyone with asthma is supported to manage their condition in primary care. Failing to act now could put more lives at risk."

The Welsh Government said it expects health boards to consider these findings and ensure children get the support they need.  

Ethan's mum Gemma said there needs to be more support available to parents like her, so her son can avoid being hospitalised in the future.

A Welsh Government spokesperson said: "We expect health boards to provide a comprehensive range of services for children with asthma. Most GP practices have an asthma nurse and we would encourage parents of children with asthma to contact their GP to make sure they have an asthma review.

"We expect health boards to consider the results of this audit and ensure children and young people get the support they need to manage their condition and prevent unnecessary hospital admissions.

"Later this year we will publish a Quality Statement for Respiratory Disease, which will set out the standards of care people can expect to receive."