I thank Emma Harper for securing this debate to mark world asthma day 2024. I also say well done to Jackie Dunbar, and urge her to keep going. I gave up smoking 22 years ago and have never looked back, so I encourage her to keep at it.
As Emma Harper and Alexander Stewart have said, this year’s theme is “Asthma Education Empowers”. That is important, because knowledge of how to access good and timely treatment can be life changing for those living with asthma.
Asthma and Lung UK’s 2024 survey revealed that basic asthma care levels continue to fall in Scotland, with only 24 per cent of sufferers receiving the three basic provisions of asthma care. Data also shows that, in Scotland, there are significantly low levels of uptake of specialist treatments such as biologics for those who might be eligible. There is a postcode lottery across Scotland. It is interesting to note that, despite its own challenges, NHS England currently leads Scotland with a 17 to 21 per cent higher uptake. There is something that we can learn from that.
Clearly, there are issues with the levels of education about and knowledge of what services are available in Scotland, in both specialist treatments and basic asthma care. However, the problem lies not with public knowledge alone; Asthma and Lung UK has reported concerns that the Scottish Government does not accurately collect and report the correct number of people living with respiratory conditions, which is an issue that anyone with an interest in long Covid will be familiar with. That matters, because poor data collection means poorer treatment options and, ultimately, poorer patient outcomes. The issue must be addressed.
Patients have also raised concerns about a lack of awareness in primary care, leading to delays in specialist referrals to clinics for patient-centred assessment and to gain an accurate diagnosis. The more that we ensure that GPs are properly supported and have the time to take opportunities to expand their knowledge of and education on subjects such as asthma, the more that we can ensure that patients are signposted and treated before their symptoms worsen or they end up in hospital.
The survey further showed that only 40 per cent of people hospitalised with asthma were getting the follow-up care that they needed within two days of leaving hospital. That is the case, despite current Scottish Intercollegiate Guidelines Network guidance stating that follow-up care is required to ensure that symptoms remain under control. The result is that around one in six people who receives emergency care for an asthma attack needs hospital care again within two weeks. There is, therefore, a logic to our getting prevention right. We know that the national health service is already under immense pressure, and the lack of that basic follow-up care only exacerbates the problem.
Patients and health professionals need support from the Scottish Government if asthma education is to actually empower them. They need better data collection, action in primary care to improve diagnostic tools and public health campaigns that provide up-to-date information about treatment. Scotland also needs the timely implementation of the respiratory care action plan’s severe asthma recommendations, the creation of clear, national, once-for-Scotland protocols for severe asthma and the establishment of nationally agreed severe asthma referral pathways, which will promote collaboration between primary and specialised care.
Without action to address those issues, asthma will continue to be a significant public health challenge in Scotland, causing pain and discomfort and placing strain on the NHS that is avoidable.
