Respiratory disease

Respiratory disease is serious, and varied. In England, 1 in 3 deaths is described as premature, that is death occurs before the age of 75 years. Of these premature deaths, three quarters are a result of cancer, heart disease, stroke, liver disease or respiratory disease, with respiratory disease accounting for 95 of this. Read the Living Well for Longer PDF document on the Gov.uk website.

Chronic Obstructive Pulmonary Disease (COPD)

The Quality and Outcomes Framework (QOF)( Public Health England) shows that 21.8 percent of people in England, according to GP records, have COPD, which is Chronic Obstructive Pulmonary Disease. Chronic Obstructive Pulmonary Disease (COPD) is a name given for a collection of chronic lung diseases including chronic bronchitis, emphysema, and chronic obstructive airways disease, which are usually associated with people who smoke – the more the individual smokes, and the longer they have been a smoker, the more the increase in likelihood of developing COPD. These people will have consistent difficulty in breathing, persistent cough with phlegm, and be prone to frequent chest infections.

It arises due to inflammation within the lungs resulting in permanent damage and less functional capacity in the lungs. Some rare cases of COPD are caused by fumes, air pollution, genetic disorders or dust, however these are unusual. Although symptoms may be apparent, the condition may be dismissed as a 'smoker’s cough', but seeking treatment may lead to a slowing down of deterioration of the lungs condition. The most effective interposition is to stop smoking. More information is available on the British Lung Foundation website.

Asthma

The UK has amongst the highest rates of asthma in the world, and its treatment and care costs the NHS approximately £1bn annually. 6 percent of people in England are recorded as having asthma, (approximately 1 in 11 children and 1 in 12 adults have asthma) a condition which may have a genetic cause, be caused by air pollution, chlorine in swimming pools, or modern hygiene standards. Asthma can be exacerbated by dust, cold air and smoke. It is most likely to occur in those with a family history of the condition. Visit the Asthma website for more details.

The actual prevalence of these conditions is likely to be much higher and they often remain undiagnosed particularly in the early stages of the conditions.

The prevalence of COPD (Chronic Obstructive Pulmonary Disease) in Wokingham is less than that in neighboring local authorities, see Figure 1, above. This is linked  to the low smoking rates in the Borough.

The prevalence of asthma in Wokingham is higher than in neighbouring boroughs (see Figure 2.)

The Department of Health 2012 presents evidence that exposure to tobacco contributes to the severity of childhood asthma. There is evidence of a direct causal relationship between parental smoking and lower respiratory tract illness in children up to 3 years of age. Read the enhancing quality of life for people with long term conditions PDF on the Gov.uk website.

People from lower socio-economic groups are at higher risk, as are very young people and older people. There is evidence that children living in homes with damp or mould are 1.5 to 3 times more likely to experience coughing and wheezing. Asthma could, therefore, be more prevalent in more deprived areas, due to the poorer housing quality. Read the housing facts and figures on the Bracknell Forest Council website for more details.

Psychological conditions such as anxiety and depression may be up to 6 times more common in people with asthma than in the general population. Read the Department of Health Outcomes Strategy for Chronic Obstructive Pulmonary Disease (COPD) and Asthma PDF on the Gov.uk website. Read the mental health facts and figures on the Bracknell Forest Council website for more details.

People with asthma need access to a service that facilitates prompt and accurate diagnosis, a treatment plan which is discussed and agreed with the person with asthma, and which provides ongoing support as the person controls his or her own condition in such a manner that the need for unscheduled healthcare is a rare event. Read the Department of Health Outcomes Strategy for Chronic Obstructive Pulmonary Disease (COPD) and Asthma PDF on the Gov.uk website.

Recommendations

Recommendations for consideration by other key organisations

There needs to be more focus on promoting self-care for asthma, in order to control the condition and prevent hospital admissions.

People with asthma should have a written action plan that helps them understand when their symptoms are getting worse and what to do about it, be trained and assessed in using their inhalers before they start using them, and have a structured review of their asthma annually, as people without action plans are four times more likely to need to go to hospital for their asthma.

Current best practices

• Read the Outcomes Strategy for People with Chronic Obstructive Pulmonary Disease (COPD) and Asthma in England PDF on the Gov.uk website